Indiana
Professional Licensing Agency
Jorge Medina
Controlled Substance Registration - Physician
License number
01061849B
Date granted
06/09/2006
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Saint Anthony - Winfield, 11161 Randolph Street, Crown Point IN 46307-8564
indianalicensing.org
ID 5841286
LAST UPDATED 2024-04-03 10:01:45 UTC
LAST UPDATED 2024-04-03 10:01:45 UTC
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