License holder summary

Michael Brian Wildermuth is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Michael Brian Wildermuth is Greater Lafayette Health Services, 517 Lingle Avenue, Lafayette IN 47901. This licensed professional license is current. The license was granted 03/23/1995 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Michael Brian Wildermuth
Controlled Substance Registration - Physician
License number
01043585B
Date granted
03/23/1995
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Greater Lafayette Health Services, 517 Lingle Avenue, Lafayette IN 47901
indianalicensing.org
ID 5880283
LAST UPDATED 2024-02-16 23:20:01 UTC

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