License holder summary

Mamak Eatesam is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Mamak Eatesam is St. Joseph, 5215 Holy Cross PKWY, Mishawaka IN 46545. This licensed professional license is current. The license was granted 10/01/2014 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Mamak Eatesam
Controlled Substance Registration - Physician
License number
01074579B
Date granted
10/01/2014
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
St. Joseph, 5215 Holy Cross PKWY, Mishawaka IN 46545
indianalicensing.org
ID 27714915
LAST UPDATED 2024-02-01 19:48:06 UTC

This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.

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