Indiana
Professional Licensing Agency
SA D EL ISSA
Controlled Substance Registration - Physician
License number
01023128B
Date granted
01/29/1970
Date expires
06/30/1984
Class
Controlled Substance Registration - Physician
Status
Expired
Address
3075 SOUTH CANAL RD, TERRE HAUTE IN 47802
indianalicensing.org
ID 5926536
LAST UPDATED 2026-04-15 23:59:24 UTC
LAST UPDATED 2026-04-15 23:59:24 UTC
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