Indiana
Professional Licensing Agency
Erin Elizabeth Datzman
Controlled Substance Registration - Physician
License number
01068164B
Date granted
04/30/2010
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
58348 County Road 27, Goshen IN 46528
indianalicensing.org
ID 5858594
LAST UPDATED 2024-03-24 02:11:17 UTC
LAST UPDATED 2024-03-24 02:11:17 UTC
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