License holder summary

Matthew M. Fornefeld is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Matthew M. Fornefeld is 481 South Landmark Avenue, Bloomington IN 47403. This licensed professional license is current. The license was granted 07/08/1986 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Matthew M. Fornefeld
Controlled Substance Registration - Physician
License number
01034586B
Date granted
07/08/1986
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
481 South Landmark Avenue, Bloomington IN 47403
indianalicensing.org
ID 5825278
LAST UPDATED 2024-02-27 01:33:35 UTC

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