Indiana
Professional Licensing Agency
Mark A. King
Controlled Substance Registration-Osteopathic Physician
License number
02001031B
Date granted
07/08/1988
Date expires
10/31/2015
Class
Controlled Substance Registration-Osteopathic Physician
Status
Active
Address
Lutheran Medical Group, 7980 W. Jefferson Blvd, Fort Wayne IN 46804
indianalicensing.org
ID 5800617
LAST UPDATED 2024-03-13 10:10:56 UTC
LAST UPDATED 2024-03-13 10:10:56 UTC
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