Indiana
Professional Licensing Agency
Mario D. Miranda
Controlled Substance Registration-Osteopathic Physician
License number
02003258B
Date granted
09/28/2007
Date expires
10/31/2015
Class
Controlled Substance Registration-Osteopathic Physician
Status
Active
Address
St. Mary Medical Center, 1500 S. Lake Park Avenue, Hobart IN 46342
indianalicensing.org
ID 5803485
LAST UPDATED 2024-03-01 18:52:12 UTC
LAST UPDATED 2024-03-01 18:52:12 UTC
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