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 2024-04-20 18:19:32 UTC
LAST UPDATED 2024-04-20 18:19:32 UTC
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