JOHNATHAN MARK MARTIN

Controlled Substance Registration - Physician

Indiana  01043987B   Active

This Indiana license is held by JOHNATHAN MARK MARTIN. The license is currently active. It was granted on 03/09/1998 and expired on 10/31/2015

LICENSE DETAILS

  • License Number: 01043987B
  • Category: CSR-Physician
  • Status: Active
  • Date Granted: 03/09/1998 (over 28 years ago)
  • Expiry Date: 10/31/2015 (over 10 years ago)

LOCATIONS

A Address

Home Hospital Medical Staff Office, 2400 South Street, Lafayette IN 47904