Indiana
Professional Licensing Agency
Tania Milad Matta
Controlled Substance Registration - Physician
License number
01060593B
Date granted
06/21/2005
Date expires
06/30/2009
Class
Controlled Substance Registration - Physician
Status
Expired
Address
915 Sagamore Pkwy West, West Lafayette IN 47906
indianalicensing.org
ID 5934623
LAST UPDATED 2024-04-12 05:54:23 UTC
LAST UPDATED 2024-04-12 05:54:23 UTC
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