Indiana
Professional Licensing Agency
EDISON ROQUE BLANCO
Controlled Substance Registration - Physician
License number
01040136B
Date granted
05/19/1992
Date expires
06/30/1997
Class
Controlled Substance Registration - Physician
Status
Expired
Address
722 WEST BRISTOL # A, ELKHART IN 46514
indianalicensing.org
ID 5847076
LAST UPDATED 2024-04-24 10:07:36 UTC
LAST UPDATED 2024-04-24 10:07:36 UTC
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