Indiana
Professional Licensing Agency
Tracy Casault
Controlled Substance Registration-Osteopathic Physician
License number
02003315B
Date granted
02/27/2008
Date expires
06/30/2009
Class
Controlled Substance Registration-Osteopathic Physician
Status
Expired
Address
Memorial Sports Medicine Institute, 111 West Jefferson Blvd, Suite 100, South Bend IN 46601
indianalicensing.org
ID 5813782
LAST UPDATED 2024-04-01 11:09:31 UTC
LAST UPDATED 2024-04-01 11:09:31 UTC
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