Ethan Edward Wagner
Controlled Substance Registration-Osteopathic Physician
Indiana 02002898B Active
This Indiana license is held by Ethan Edward Wagner. The license is currently active. It was granted on 04/07/2005 and expired on 10/31/2015
LICENSE DETAILS
- License Number: 02002898B
- Category: CSR-Osteopathic Physician
- Status: Active
- Date Granted: 04/07/2005 (over 20 years ago)
- Expiry Date: 10/31/2015 (over 9 years ago)
LOCATIONS
A Address
12472 Cirrus Drive, Fishers IN 46037
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