Indiana
Professional Licensing Agency
Mallik V. V. A. S. Chaganti
Controlled Substance Registration - Physician
License number
01055341B
Date granted
06/04/2002
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Clinic of Family Medicine, 1103 E. Grace St., Rensselaer IN 47978
indianalicensing.org
ID 5912439
LAST UPDATED 2024-05-11 08:04:17 UTC
LAST UPDATED 2024-05-11 08:04:17 UTC
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