Indiana
Professional Licensing Agency
Olaf B Johansen
Controlled Substance Registration - Physician
License number
01040001B
Date granted
02/27/1992
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Kendrick Regional Center for Colon and Rectal Care, 1215 Hadley Road, Mooresville IN 46158
indianalicensing.org
ID 5897145
LAST UPDATED 2024-02-14 11:41:45 UTC
LAST UPDATED 2024-02-14 11:41:45 UTC
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