Indiana
Professional Licensing Agency
Nicholas John Datzman
Controlled Substance Registration - Physician
License number
01066396B
Date granted
04/14/2009
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
58348 County Road 27, Goshen IN 46528
indianalicensing.org
ID 5858965
LAST UPDATED 2024-04-10 19:56:40 UTC
LAST UPDATED 2024-04-10 19:56:40 UTC
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