Indiana
Professional Licensing Agency
David O. Magnante
Controlled Substance Registration - Physician
License number
01045133B
Date granted
05/23/1996
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
975 Mezanine Drive,Suite B, Lafayette IN 47905
indianalicensing.org
ID 5879115
LAST UPDATED 2024-02-16 20:17:40 UTC
LAST UPDATED 2024-02-16 20:17:40 UTC
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