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
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