Marylin Ann Datzman
Controlled Substance Registration - Physician
Indiana 01028568C Expired
This Indiana license was held by Marylin Ann Datzman. The license is no longer active. It was granted on 10/25/1985 and expired on 06/30/1987
LICENSE DETAILS
- License Number: 01028568C
- Category: CSR-Physician
- Status: Expired
- Date Granted: 10/25/1985 (over 39 years ago)
- Expiry Date: 06/30/1987 (almost 38 years ago)
LOCATIONS
A Address
1520 23RD STREET #C, BEDFORD IN 47421