Nikolay Petrov Mitzov
Controlled Substance Registration - Physician
Indiana 01056818B Expired
This Indiana license was held by Nikolay Petrov Mitzov. The license is no longer active. It was granted on 09/25/2002 and expired on 06/30/2009
LICENSE DETAILS
- License Number: 01056818B
- Category: CSR-Physician
- Status: Expired
- Date Granted: 09/25/2002 (over 23 years ago)
- Expiry Date: 06/30/2009 (almost 17 years ago)
LOCATIONS
A Address
2627 W 1000 S, Pendleton IN 46064