License holder summary

JOHN V DEFAZIO is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for JOHN V DEFAZIO is Medical Center of Southern Indiana, 2200 Market St., P.O. Box 69, Charlestown IN 47111-0069. This licensed professional license is not current. The license was granted 02/07/2003 and expired on 06/30/2005.

Indiana

Professional Licensing Agency

JOHN V DEFAZIO
Controlled Substance Registration - Physician
License number
01048774B
Date granted
02/07/2003
Date expires
06/30/2005
Class
Controlled Substance Registration - Physician
Status
Expired
Address
Medical Center of Southern Indiana, 2200 Market St., P.O. Box 69, Charlestown IN 47111-0069
indianalicensing.org
ID 5833118
LAST UPDATED 2024-02-27 15:09:43 UTC

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