License holder summary

Jon David Leipold is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Jon David Leipold is 5776 51 GRAPE ROAD SUITE 230, MISHAWAKA IN 46545. This licensed professional license is current. The license was granted 05/31/1983 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Jon David Leipold
Controlled Substance Registration - Physician
License number
01020477B
Date granted
05/31/1983
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
5776 51 GRAPE ROAD SUITE 230, MISHAWAKA IN 46545
indianalicensing.org
ID 5895241
LAST UPDATED 2024-02-06 18:27:23 UTC

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