Indiana
Professional Licensing Agency
Christiaan Nikolaje Mamczak
Controlled Substance Registration-Osteopathic Physician
License number
02004231B
Date granted
06/14/2013
Date expires
10/31/2015
Class
Controlled Substance Registration-Osteopathic Physician
Status
Active
Address
Memorial Medical Group, 100 Navarre Place, Ste 5500, South Bend IN 46601
indianalicensing.org
ID 5813228
LAST UPDATED 2024-02-21 02:14:16 UTC
LAST UPDATED 2024-02-21 02:14:16 UTC
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