Indiana
Professional Licensing Agency
Frederick M. Tiesenga
Controlled Substance Registration - Physician
License number
01058355B
Date granted
11/07/2003
Date expires
06/30/2005
Class
Controlled Substance Registration - Physician
Status
Expired
Address
St. Margaret Mercy, att: S. Golonka, 5454 Hohman Ave, Hammond IN 46320
indianalicensing.org
ID 5863965
LAST UPDATED 2024-02-25 23:53:57 UTC
LAST UPDATED 2024-02-25 23:53:57 UTC
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