Mark R. Fantauzzi
Controlled Substance Registration-Osteopathic Physician
Indiana 02001815B Expired
This Indiana license was held by Mark R. Fantauzzi. The license is no longer active. It was granted on 01/23/1997 and expired on 06/30/2011
LICENSE DETAILS
- License Number: 02001815B
- Category: CSR-Osteopathic Physician
- Status: Expired
- Date Granted: 01/23/1997 (over 28 years ago)
- Expiry Date: 06/30/2011 (almost 14 years ago)
LOCATIONS
A Address
Parkview Hosp Medical Staff Office, 2200 Randallia, Fort Wayne IN 46815