Emmanuel Baltazar Favila
Controlled Substance Registration - Physician
Indiana 01039992B Active
This Indiana license is held by Emmanuel Baltazar Favila. The license is currently active. It was granted on 02/27/1992 and expired on 10/31/2015
LICENSE DETAILS
- License Number: 01039992B
- Category: CSR-Physician
- Status: Active
- Date Granted: 02/27/1992 (about 33 years ago)
- Expiry Date: 10/31/2015 (over 9 years ago)
LOCATIONS
A Address
97 East Halt Drive, TERRE HAUTE IN 47802
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