License holder summary

MARCO JOHN DIBIASE is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for MARCO JOHN DIBIASE is 8865 WEST 400 NORTH STE 115, MICHIGAN CITY IN 46360. This licensed professional license is not current. The license was granted 01/31/1986 and expired on 06/30/2005.

Indiana

Professional Licensing Agency

MARCO JOHN DIBIASE
Controlled Substance Registration - Physician
License number
01029738B
Date granted
01/31/1986
Date expires
06/30/2005
Class
Controlled Substance Registration - Physician
Status
Expired
Address
8865 WEST 400 NORTH STE 115, MICHIGAN CITY IN 46360
indianalicensing.org
ID 5893090
LAST UPDATED 2024-05-08 21:26:42 UTC

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