Indiana
Professional Licensing Agency
Matthew Jay Fackrell
Controlled Substance Registration-Osteopathic Physician
License number
02002954B
Date granted
06/23/2005
Date expires
06/30/2007
Class
Controlled Substance Registration-Osteopathic Physician
Status
Expired
Address
Fort Wayne Medical Education Program, 2434 Lake Avenue, Fort Wayne IN 46805
indianalicensing.org
ID 5800679
LAST UPDATED 2024-04-13 04:52:28 UTC
LAST UPDATED 2024-04-13 04:52:28 UTC
This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.