Indiana
Professional Licensing Agency
Perkin Knot Stang
Controlled Substance Registration - Physician
License number
01056783B
Date granted
10/02/2002
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
99 East 86th Street, Suite B, Merrillville IN 46410-6267
indianalicensing.org
ID 5891264
LAST UPDATED 2024-02-24 19:51:30 UTC
LAST UPDATED 2024-02-24 19:51:30 UTC
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