Indiana
Professional Licensing Agency
Jay D. Fawver
Controlled Substance Registration - Physician
License number
01032403C
Date granted
03/23/1990
Date expires
06/30/1997
Class
Controlled Substance Registration - Physician
Status
Expired
Address
OTIS R BOWEN CENTER, 850 NORTH HARRISON STREET, WARSAW IN 46580
indianalicensing.org
ID 5932626
LAST UPDATED 2024-04-01 20:50:31 UTC
LAST UPDATED 2024-04-01 20:50:31 UTC
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