ALFONSO LOPEZ
Controlled Substance Registration - Physician
Indiana 01020564B Expired
This Indiana license was held by ALFONSO LOPEZ. The license is no longer active. It was granted on 05/31/1986 and expired on 06/30/2003
LICENSE DETAILS
- License Number: 01020564B
- Category: CSR-Physician
- Status: Expired
- Date Granted: 05/31/1986 (about 40 years ago)
- Expiry Date: 06/30/2003 (almost 23 years ago)
LOCATIONS
A Address
P O BOX 1092, 446 WEST ARCH STREET, PORTLAND IN 47371