Emmanuel Baltazar Favila
Controlled Substance Registration - Physician
Indiana 01039992E Expired
This Indiana license was held by Emmanuel Baltazar Favila. The license is no longer active. It was granted on 07/08/1994 and expired on 06/30/1995
LICENSE DETAILS
- License Number: 01039992E
- Category: CSR-Physician
- Status: Expired
- Date Granted: 07/08/1994 (almost 31 years ago)
- Expiry Date: 06/30/1995 (almost 30 years ago)
LOCATIONS
A Address
INDIANA MEDICAL SPECIALISTS INC, 122 WEST MAIN ST, JASONVILLE IN 47438