Indiana
Professional Licensing Agency
John Van Wienen
Controlled Substance Registration - Physician
License number
01016259B
Date granted
09/30/1986
Date expires
06/30/1987
Class
Controlled Substance Registration - Physician
Status
Expired
Address
193 EAST WASHINGTON STREET, MARTINSVILLE IN 46151
indianalicensing.org
ID 5889218
LAST UPDATED 2024-02-16 20:05:51 UTC
LAST UPDATED 2024-02-16 20:05:51 UTC
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