Indiana
Professional Licensing Agency
Dale Dellacqua
Controlled Substance Registration - Physician
License number
01050231C
Date granted
05/22/2001
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
639 S. Walker Street, Suite E, Bloomington IN 47403
indianalicensing.org
ID 5824000
LAST UPDATED 2024-04-24 02:29:18 UTC
LAST UPDATED 2024-04-24 02:29:18 UTC
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