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