License holder summary

Ima A Test Zzz03 is a Controlled Substance Registration-Osteopathic Physician licensed to practice in Indiana. The address on file for Ima A Test Zzz03 is CSR B DO, 402 W. Washington St. Room W072, Indianapolis IN 46204. This licensed professional license is not current. The license was granted 01/01/1990 and expired on 10/31/2013.

Indiana

Professional Licensing Agency

Ima A Test Zzz03
Controlled Substance Registration-Osteopathic Physician
License number
02000000B
Date granted
01/01/1990
Date expires
10/31/2013
Class
Controlled Substance Registration-Osteopathic Physician
Status
Expired
Address
CSR B DO, 402 W. Washington St. Room W072, Indianapolis IN 46204
indianalicensing.org
ID 5805395
LAST UPDATED 2024-03-31 11:23:06 UTC

This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.

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