License holder summary

Fazal Mohammad is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Fazal Mohammad is La Porte Regional Medical Center, 1007 Lincolnway, La Porte IN 46350. This licensed professional license is current. The license was granted 06/28/2010 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Fazal Mohammad
Controlled Substance Registration - Physician
License number
01068409B
Date granted
06/28/2010
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
La Porte Regional Medical Center, 1007 Lincolnway, La Porte IN 46350
indianalicensing.org
ID 5877903
LAST UPDATED 2024-03-07 16:45:24 UTC

This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.

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