Indiana
Professional Licensing Agency
Mary Barbara Backer
Controlled Substance Registration - Physician
License number
01017394B
Date granted
04/30/1986
Date expires
06/30/2001
Class
Controlled Substance Registration - Physician
Status
Expired
Address
301 WILLOWBEND DRIVE, LAPORTE IN 46350
indianalicensing.org
ID 5878277
LAST UPDATED 2024-02-04 17:59:48 UTC
LAST UPDATED 2024-02-04 17:59:48 UTC
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