Indiana
Professional Licensing Agency
Mario Daniel Mansueto
Controlled Substance Registration - Physician
License number
01017859B
Date granted
02/28/1986
Date expires
06/30/2003
Class
Controlled Substance Registration - Physician
Status
Expired
Address
1328 Park Drive, Munster IN 46321
indianalicensing.org
ID 5900899
LAST UPDATED 2024-03-23 07:28:22 UTC
LAST UPDATED 2024-03-23 07:28:22 UTC
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