Indiana
Professional Licensing Agency
Grant Chavin
Temporary Medical Doctor Permit
License number
99041590A
Date granted
03/18/2010
Date expires
06/18/2010
Class
Temporary Medical Doctor Permit
Status
Superceded
Address
Munster IN 46321
indianalicensing.org
ID 6136463
LAST UPDATED 2026-05-19 02:00:09 UTC
LAST UPDATED 2026-05-19 02:00:09 UTC
This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.