License holder summary

Kosin Thupvong is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Kosin Thupvong is LAKE PORTER CARDIOVASCULAR P C, 8687 CONNECTICUT STREET BLDG 3, MERRILLVILLE IN 46410. This licensed professional license is not current. The license was granted 07/31/1986 and expired on 10/31/2013.

Indiana

Professional Licensing Agency

Kosin Thupvong
Controlled Substance Registration - Physician
License number
01025644B
Date granted
07/31/1986
Date expires
10/31/2013
Class
Controlled Substance Registration - Physician
Status
Expired
Address
LAKE PORTER CARDIOVASCULAR P C, 8687 CONNECTICUT STREET BLDG 3, MERRILLVILLE IN 46410
indianalicensing.org
ID 5890810
LAST UPDATED 2024-03-27 16:29:09 UTC

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