Indiana
Professional Licensing Agency
Blas Flores Mamaril
Controlled Substance Registration - Physician
License number
01022254B
Date granted
02/28/1986
Date expires
06/30/2003
Class
Controlled Substance Registration - Physician
Status
Expired
Address
3715 Henry Drive, Logansport IN 46947
indianalicensing.org
ID 5884754
LAST UPDATED 2024-04-09 15:42:50 UTC
LAST UPDATED 2024-04-09 15:42:50 UTC
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