Indiana
Professional Licensing Agency
Don Squires Dunevant
Controlled Substance Registration - Physician
License number
01033863B
Date granted
10/31/1984
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
3630 WILLOWCREEK ROAD, PORTAGE IN 46368
indianalicensing.org
ID 5910980
LAST UPDATED 2024-04-24 17:24:32 UTC
LAST UPDATED 2024-04-24 17:24:32 UTC
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