Indiana
Professional Licensing Agency
Benito Blanco Perez
Controlled Substance Registration - Physician
License number
01054872B
Date granted
01/15/2002
Date expires
06/30/2009
Class
Controlled Substance Registration - Physician
Status
Expired
Address
Prime Care Physician Network, 1150 1/2 Lincoln Way South, Ligonier IN 46767
indianalicensing.org
ID 5884374
LAST UPDATED 2024-03-10 19:38:08 UTC
LAST UPDATED 2024-03-10 19:38:08 UTC
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