Indiana
Professional Licensing Agency
Nova Law
Controlled Substance Registration - Physician
License number
01057020B
Date granted
12/02/2002
Date expires
06/30/2003
Class
Controlled Substance Registration - Physician
Status
Expired
Address
Gary IN 46404
indianalicensing.org
ID 5857183
LAST UPDATED 2024-02-18 04:10:26 UTC
LAST UPDATED 2024-02-18 04:10:26 UTC
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