License holder summary

Leonard I. Mastbaum is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Leonard I. Mastbaum is INDIANA REGIONAL MEDICAL CONSULTANTS INC, 7900 W JEFFERSON BLVD STE 201, FORT WAYNE IN 46804. This licensed professional license is not current. The license was granted 04/29/1993 and expired on 06/30/2009.

Indiana

Professional Licensing Agency

Leonard I. Mastbaum
Controlled Substance Registration - Physician
License number
01041346B
Date granted
04/29/1993
Date expires
06/30/2009
Class
Controlled Substance Registration - Physician
Status
Expired
Address
INDIANA REGIONAL MEDICAL CONSULTANTS INC, 7900 W JEFFERSON BLVD STE 201, FORT WAYNE IN 46804
indianalicensing.org
ID 5853892
LAST UPDATED 2024-03-01 16:30:22 UTC

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