CHAWTIPYA THUPVONG
Controlled Substance Registration - Physician
Indiana 01025822B Expired
This Indiana license was held by CHAWTIPYA THUPVONG. The license is no longer active. It was granted on 10/10/1985 and expired on 06/30/2011
LICENSE DETAILS
- License Number: 01025822B
- Category: CSR-Physician
- Status: Expired
- Date Granted: 10/10/1985 (over 38 years ago)
- Expiry Date: 06/30/2011 (about 13 years ago)
LOCATIONS
A Address
ST ANTHONY MEDICAL CENTER, 1201 SOUTH MAIN STREET, CROWN POINT IN 46307