Indiana
Professional Licensing Agency
John Thorsen Scully
Controlled Substance Registration - Physician
License number
01017621B
Date granted
01/31/1986
Date expires
06/30/2005
Class
Controlled Substance Registration - Physician
Status
Expired
Address
483 Roxbury Rd., Valparaiso IN 46385
indianalicensing.org
ID 5928850
LAST UPDATED 2024-05-02 17:29:48 UTC
LAST UPDATED 2024-05-02 17:29:48 UTC
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