License holder summary

Stephen Richard Phillipp is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Stephen Richard Phillipp is 6119 WEST JEFFERSON BLVD, FORT WAYNE IN 46804. This licensed professional license is current. The license was granted 06/30/1985 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Stephen Richard Phillipp
Controlled Substance Registration - Physician
License number
01029911B
Date granted
06/30/1985
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
6119 WEST JEFFERSON BLVD, FORT WAYNE IN 46804
indianalicensing.org
ID 5854534
LAST UPDATED 2024-04-05 18:02:44 UTC

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