License holder summary

Emmanuel Baltazar Favila is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Emmanuel Baltazar Favila is INDIANA MEDICAL SPECIALISTS INC, 1011 E NATIONAL AVE, BRAZIL IN 47834. This licensed professional license is not current. The license was granted 07/08/1994 and expired on 06/30/1995.

Indiana

Professional Licensing Agency

Emmanuel Baltazar Favila
Controlled Substance Registration - Physician
License number
01039992D
Date granted
07/08/1994
Date expires
06/30/1995
Class
Controlled Substance Registration - Physician
Status
Expired
Address
INDIANA MEDICAL SPECIALISTS INC, 1011 E NATIONAL AVE, BRAZIL IN 47834
indianalicensing.org
ID 5827588
LAST UPDATED 2024-03-05 19:59:46 UTC

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