Indiana
Professional Licensing Agency
Deanna S. Porte Keene
Controlled Substance Registration - Physician
License number
01029185B
Date granted
05/31/1986
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
1650 45th Avenue #C, Munster IN 46321
indianalicensing.org
ID 5900094
LAST UPDATED 2024-03-06 01:07:59 UTC
LAST UPDATED 2024-03-06 01:07:59 UTC
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