License holder summary

FORREST R LAFOLLETTE is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for FORREST R LAFOLLETTE is 1445 PARK DRIVE, MUNSTER IN 46321. This licensed professional license is not current. The license was granted 05/31/1986 and expired on 06/30/1989.

Indiana

Professional Licensing Agency

FORREST R LAFOLLETTE
Controlled Substance Registration - Physician
License number
01014026B
Date granted
05/31/1986
Date expires
06/30/1989
Class
Controlled Substance Registration - Physician
Status
Expired
Address
1445 PARK DRIVE, MUNSTER IN 46321
indianalicensing.org
ID 5900260
LAST UPDATED 2024-03-21 15:22:11 UTC

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