License holder summary

JUAN M LASA JR is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for JUAN M LASA JR is WESTVILLE CORRECTIONAL CENTER, P O BOX 473, WESTVILLE IN 46391. This licensed professional license is not current. The license was granted 07/28/1994 and expired on 06/30/1999.

Indiana

Professional Licensing Agency

JUAN M LASA JR
Controlled Substance Registration - Physician
License number
01042885B
Date granted
07/28/1994
Date expires
06/30/1999
Class
Controlled Substance Registration - Physician
Status
Expired
Address
WESTVILLE CORRECTIONAL CENTER, P O BOX 473, WESTVILLE IN 46391
indianalicensing.org
ID 5935054
LAST UPDATED 2024-01-30 03:28:21 UTC

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