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