Indiana
Professional Licensing Agency
Michael Lewis Blakesley
Controlled Substance Registration - Physician
License number
01028547B
Date granted
04/30/1986
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
615 NORTH MICHIGAN STREET, SOUTH BEND IN 46601
indianalicensing.org
ID 5921769
LAST UPDATED 2024-03-08 08:39:46 UTC
LAST UPDATED 2024-03-08 08:39:46 UTC
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