Indiana
Professional Licensing Agency
Mutena Biliker Korman
Controlled Substance Registration - Physician
License number
01055605B
Date granted
03/11/2002
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
3820 Central Ave, Lake Station IN 46405
indianalicensing.org
ID 5881237
LAST UPDATED 2024-03-14 11:02:02 UTC
LAST UPDATED 2024-03-14 11:02:02 UTC
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