Indiana
Professional Licensing Agency
Stephen M. Lantz
Controlled Substance Registration - Physician
License number
01021528B
Date granted
08/11/1995
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Community Occupational Medicine, LLC, 2312 Eisenhower Drive N, Goshen IN 46526
indianalicensing.org
ID 5859164
LAST UPDATED 2024-04-09 23:20:54 UTC
LAST UPDATED 2024-04-09 23:20:54 UTC
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