JOHN ROBERT WAGONER
Controlled Substance Registration - Physician
Indiana 01015790B Expired
This Indiana license was held by JOHN ROBERT WAGONER. The license is no longer active. It was granted on 09/30/1986 and expired on 06/30/1997
LICENSE DETAILS
- License Number: 01015790B
- Category: CSR-Physician
- Status: Expired
- Date Granted: 09/30/1986 (over 39 years ago)
- Expiry Date: 06/30/1997 (almost 29 years ago)
LOCATIONS
A Address
2201 EAST P O BOX 501, NORTH MANCHESTER IN 46962