Indiana
Professional Licensing Agency
David A Rivera
Controlled Substance Registration - Physician
License number
01059497B
Date granted
07/09/2004
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Life Stages Women's Health Ctr., 1401 Memorial Avenue A, Washington IN 47501
indianalicensing.org
ID 5933105
LAST UPDATED 2024-02-03 12:24:09 UTC
LAST UPDATED 2024-02-03 12:24:09 UTC
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