Indiana
Professional Licensing Agency
David C. Gastineau
Controlled Substance Registration - Physician
License number
01015232B
Date granted
12/31/1985
Date expires
06/30/1991
Class
Controlled Substance Registration - Physician
Status
Expired
Address
2200 LAKE AVE #150, FORT WAYNE IN 46805
indianalicensing.org
ID 5853180
LAST UPDATED 2024-04-18 01:32:47 UTC
LAST UPDATED 2024-04-18 01:32:47 UTC
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