License holder summary

Michael Joseph Destefano is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Michael Joseph Destefano is 100 Navarre Place, Suite 4470, South Bend IN 46601. This licensed professional license is current. The license was granted 07/31/1986 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Michael Joseph Destefano
Controlled Substance Registration - Physician
License number
01027434B
Date granted
07/31/1986
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
100 Navarre Place, Suite 4470, South Bend IN 46601
indianalicensing.org
ID 5921766
LAST UPDATED 2026-05-26 14:23:39 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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