Indiana
Professional Licensing Agency
Elliot Jay Blumenthal
Controlled Substance Registration - Physician
License number
01025560B
Date granted
07/31/1986
Date expires
10/31/2013
Class
Controlled Substance Registration - Physician
Status
Expired Non-Renewable
Address
3120 Caroline Street, South Bend IN 46614
indianalicensing.org
ID 5920858
LAST UPDATED 2024-04-20 09:34:36 UTC
LAST UPDATED 2024-04-20 09:34:36 UTC
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