Indiana
Professional Licensing Agency
Philip Anthony Decker
Controlled Substance Registration - Physician
License number
01056579C
Date granted
01/08/2004
Date expires
06/30/2005
Class
Controlled Substance Registration - Physician
Status
Expired
Address
1116 Millis Ave. PO Box 629, Boonville IN 47601
indianalicensing.org
ID 5827403
LAST UPDATED 2024-03-30 23:43:44 UTC
LAST UPDATED 2024-03-30 23:43:44 UTC
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