Indiana
Professional Licensing Agency
Prevesh Kumar Rustagi
Controlled Substance Registration - Physician
License number
01035370B
Date granted
07/25/1986
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
2414 EAST STATE BLVD #301, FORT WAYNE IN 46805
indianalicensing.org
ID 5854201
LAST UPDATED 2024-02-19 03:25:07 UTC
LAST UPDATED 2024-02-19 03:25:07 UTC
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