License holder summary

THOMAS LOVELAND POULIN is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for THOMAS LOVELAND POULIN is CENTENNIAL MEDICAL SQUARE #302, 621 MEMORIAL DRIVE, SOUTH BEND IN 46601. This licensed professional license is current. The license was granted 05/31/1986 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

THOMAS LOVELAND POULIN
Controlled Substance Registration - Physician
License number
01023972B
Date granted
05/31/1986
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
CENTENNIAL MEDICAL SQUARE #302, 621 MEMORIAL DRIVE, SOUTH BEND IN 46601
indianalicensing.org
ID 5922404
LAST UPDATED 2024-04-17 06:04:48 UTC

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