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 2026-04-11 14:41:47 UTC
LAST UPDATED 2026-04-11 14:41:47 UTC
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