License holder summary

REGINALD B STILES is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for REGINALD B STILES is LAKE AVENUE MEDICAL BLDG, 3217 LAKE AVENUE, FORT WAYNE IN 46805. This licensed professional license is not current. The license was granted 09/30/1984 and expired on 06/30/2009.

Indiana

Professional Licensing Agency

REGINALD B STILES
Controlled Substance Registration - Physician
License number
01029564B
Date granted
09/30/1984
Date expires
06/30/2009
Class
Controlled Substance Registration - Physician
Status
Expired
Address
LAKE AVENUE MEDICAL BLDG, 3217 LAKE AVENUE, FORT WAYNE IN 46805
indianalicensing.org
ID 5854233
LAST UPDATED 2023-12-30 03:19:13 UTC

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