Indiana
Professional Licensing Agency
Justin Michael Grannell
Controlled Substance Registration-Osteopathic Physician
License number
02003881B
Date granted
07/06/2011
Date expires
10/31/2015
Class
Controlled Substance Registration-Osteopathic Physician
Status
Active
Address
Fort Wayne Medical Education Program, 750 Broadway Suite# 350, Fort Wayne IN 46802
indianalicensing.org
ID 5800552
LAST UPDATED 2024-04-24 17:40:41 UTC
LAST UPDATED 2024-04-24 17:40:41 UTC
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