Mary VanKooten

Controlled Substance Registration - Physician

Indiana  01057928B   Active

This Indiana license is held by Mary VanKooten. The license is currently active. It was granted on 08/27/2004 and expired on 10/31/2015

LICENSE DETAILS

  • License Number: 01057928B
  • Category: CSR-Physician
  • Status: Active
  • Date Granted: 08/27/2004 (about 22 years ago)
  • Expiry Date: 10/31/2015 (almost 11 years ago)

LOCATIONS

A Address

421 S. Landmark Avenue, Bloomington IN 47403