Indiana
Professional Licensing Agency
Irene Goldstein
Controlled Substance Registration - Physician
License number
01059620B
Date granted
10/12/2004
Date expires
10/31/2013
Class
Controlled Substance Registration - Physician
Status
Expired
Address
Medical Staff Office, 24 Joliet St, Dyer IN 46311
indianalicensing.org
ID 5844354
LAST UPDATED 2024-03-09 10:27:13 UTC
LAST UPDATED 2024-03-09 10:27:13 UTC
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