Indiana
Professional Licensing Agency
Kevin Michael Small
Controlled Substance Registration - Physician
License number
01044597B
Date granted
06/13/1997
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Radiology, Inc., 620 Edison Road, Suite 110, Mishawaka IN 46545
indianalicensing.org
ID 5895384
LAST UPDATED 2024-05-05 17:59:19 UTC
LAST UPDATED 2024-05-05 17:59:19 UTC
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