License holder summary

Christiaan Nikolaje Mamczak is a Controlled Substance Registration-Osteopathic Physician licensed to practice in Indiana. The address on file for Christiaan Nikolaje Mamczak is Memorial Medical Group, 100 Navarre Place, Ste 5500, South Bend IN 46601. This licensed professional license is current. The license was granted 06/14/2013 and expired on 10/31/2015.

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

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