License holder summary

Jacob Mathew is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Jacob Mathew is Lakeside Surgery Center, 810 West Chicago Avenue, East Chicago IN 46312. This licensed professional license is current. The license was granted 01/22/2013 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Jacob Mathew
Controlled Substance Registration - Physician
License number
01028065C
Date granted
01/22/2013
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Lakeside Surgery Center, 810 West Chicago Avenue, East Chicago IN 46312
indianalicensing.org
ID 5845371
LAST UPDATED 2024-02-23 03:44:30 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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