License holder summary

NANA N MIZUGUCHI is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for NANA N MIZUGUCHI is SCOTT MEMORIAL HOSP/MED CREDENTIALS, 1451 N GARDNER ST, SCOTTSBURG IN 47170. This licensed professional license is not current. The license was granted 11/05/1998 and expired on 06/30/2001.

Indiana

Professional Licensing Agency

NANA N MIZUGUCHI
Controlled Substance Registration - Physician
License number
01049339B
Date granted
11/05/1998
Date expires
06/30/2001
Class
Controlled Substance Registration - Physician
Status
Expired
Address
SCOTT MEMORIAL HOSP/MED CREDENTIALS, 1451 N GARDNER ST, SCOTTSBURG IN 47170
indianalicensing.org
ID 5917872
LAST UPDATED 2024-03-10 10:19:42 UTC

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