Indiana
Professional Licensing Agency
Fred Adolph Simon, Jr.
Controlled Substance Registration - Physician
License number
01038692B
Date granted
08/15/1990
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Fairhaven Obstetrics & Gynecology, 1111 Lighthouse Lane, Goshen IN 46526-3824
indianalicensing.org
ID 5858606
LAST UPDATED 2024-03-03 22:52:45 UTC
LAST UPDATED 2024-03-03 22:52:45 UTC
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