Indiana
Professional Licensing Agency
WILLIAM DITMARS PROVINCE
Controlled Substance Registration - Physician
License number
01014869C
Date granted
12/26/1945
Date expires
12/31/1985
Class
Controlled Substance Registration - Physician
Status
Expired
Address
100 NORTH MAIN STREET, FRANKLIN IN 46131
indianalicensing.org
ID 5855773
LAST UPDATED 2024-03-31 07:13:49 UTC
LAST UPDATED 2024-03-31 07:13:49 UTC
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