License holder summary

JOHNATHAN MARK MARTIN is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for JOHNATHAN MARK MARTIN is Home Hospital Medical Staff Office, 2400 South Street, Lafayette IN 47904. This licensed professional license is current. The license was granted 03/09/1998 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

JOHNATHAN MARK MARTIN
Controlled Substance Registration - Physician
License number
01043987B
Date granted
03/09/1998
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Home Hospital Medical Staff Office, 2400 South Street, Lafayette IN 47904
indianalicensing.org
ID 5879973
LAST UPDATED 2024-02-07 22:50:57 UTC

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