License holder summary

Mary VanKooten is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Mary VanKooten is 421 S. Landmark Avenue, Bloomington IN 47403. This licensed professional license is current. The license was granted 08/27/2004 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Mary VanKooten
Controlled Substance Registration - Physician
License number
01057928B
Date granted
08/27/2004
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
421 S. Landmark Avenue, Bloomington IN 47403
indianalicensing.org
ID 5825258
LAST UPDATED 2024-03-05 08:23:10 UTC

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