Indiana
Professional Licensing Agency
V J Tristram O Vailoces
Controlled Substance Registration - Physician
License number
01047038C
Date granted
05/22/2001
Date expires
06/30/2005
Class
Controlled Substance Registration - Physician
Status
Expired
Address
Heart City Health Center, 236 Simpson St., Elkhart IN 46516
indianalicensing.org
ID 5848669
LAST UPDATED 2024-04-01 23:52:18 UTC
LAST UPDATED 2024-04-01 23:52:18 UTC
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