License holder summary

JOHN ROBERT WAGONER is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for JOHN ROBERT WAGONER is 2201 EAST P O BOX 501, NORTH MANCHESTER IN 46962. This licensed professional license is not current. The license was granted 09/30/1986 and expired on 06/30/1997.

Indiana

Professional Licensing Agency

JOHN ROBERT WAGONER
Controlled Substance Registration - Physician
License number
01015790B
Date granted
09/30/1986
Date expires
06/30/1997
Class
Controlled Substance Registration - Physician
Status
Expired
Address
2201 EAST P O BOX 501, NORTH MANCHESTER IN 46962
indianalicensing.org
ID 5907550
LAST UPDATED 2024-04-20 09:13:34 UTC

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