John Edward Wagoner
Controlled Substance Registration - Physician
Indiana 01020202B Active
This Indiana license is held by John Edward Wagoner. The license is currently active. It was granted on 09/30/1986 and expired on 10/31/2015
LICENSE DETAILS
- License Number: 01020202B
- Category: CSR-Physician
- Status: Active
- Date Granted: 09/30/1986 (almost 40 years ago)
- Expiry Date: 10/31/2015 (almost 11 years ago)
LOCATIONS
A Address
1627 Skyline Road, Lafayette IN 47905-5590
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