License holder summary

WALTER SAMUEL MASSANARI is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for WALTER SAMUEL MASSANARI is 1404 1 PEMBROKE CIRCLE, GOSHEN IN 46526. This licensed professional license is not current. The license was granted 02/28/1983 and expired on 06/30/1999.

Indiana

Professional Licensing Agency

WALTER SAMUEL MASSANARI
Controlled Substance Registration - Physician
License number
01016675B
Date granted
02/28/1983
Date expires
06/30/1999
Class
Controlled Substance Registration - Physician
Status
Expired
Address
1404 1 PEMBROKE CIRCLE, GOSHEN IN 46526
indianalicensing.org
ID 5859285
LAST UPDATED 2026-04-12 22:13:17 UTC

This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.

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