License holder summary

Matthew Polet Datzman is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Matthew Polet Datzman is St Mary's Warrick Hospital, 1116 Millis Avenue, Boonville IN 47601. This licensed professional license is current. The license was granted 03/05/2010 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Matthew Polet Datzman
Controlled Substance Registration - Physician
License number
01036665C
Date granted
03/05/2010
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
St Mary's Warrick Hospital, 1116 Millis Avenue, Boonville IN 47601
indianalicensing.org
ID 5827359
LAST UPDATED 2024-04-12 12:49:28 UTC

This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.

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