Indiana
Professional Licensing Agency
George Enrico DePhillips
Controlled Substance Registration - Physician
License number
01073341B
Date granted
02/06/2014
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Beacon Medical Group- Elkhart, 500 Arcade Blvd, Ste 200, Elkhart IN 46514
indianalicensing.org
ID 27704113
LAST UPDATED 2024-02-02 04:03:10 UTC
LAST UPDATED 2024-02-02 04:03:10 UTC
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