Indiana
Professional Licensing Agency
John David Reisman
Controlled Substance Registration - Physician
License number
01040939B
Date granted
01/11/1993
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
2600 Greenbush Street, Lafayette IN 47904
indianalicensing.org
ID 5879840
LAST UPDATED 2024-02-07 19:48:51 UTC
LAST UPDATED 2024-02-07 19:48:51 UTC
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