License holder summary

Idah Mary Cannon is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Idah Mary Cannon is TATUM HEALTH CENTER, 1619 WEST 5TH AVE, GARY IN 46404. This licensed professional license is not current. The license was granted 05/25/1989 and expired on 06/30/2003.

Indiana

Professional Licensing Agency

Idah Mary Cannon
Controlled Substance Registration - Physician
License number
01037499B
Date granted
05/25/1989
Date expires
06/30/2003
Class
Controlled Substance Registration - Physician
Status
Expired
Address
TATUM HEALTH CENTER, 1619 WEST 5TH AVE, GARY IN 46404
indianalicensing.org
ID 5856695
LAST UPDATED 2026-05-04 15:15:27 UTC

This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.

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