Indiana
Professional Licensing Agency
Kobjit Waran Heaton
Controlled Substance Registration - Physician
License number
01057318B
Date granted
04/07/2003
Date expires
06/30/2007
Class
Controlled Substance Registration - Physician
Status
Expired
Address
1400 S. Lake Park Avenue, Suite 405, Hobart IN 46342
indianalicensing.org
ID 5867335
LAST UPDATED 2024-03-11 17:45:46 UTC
LAST UPDATED 2024-03-11 17:45:46 UTC
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