ERIC JAY GOLDENBERG MD - Medical Doctor License in Indiana | # 33*****95

ERIC JAY GOLDENBERG MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****95

License Status

NOT RENEWED

Business

N

Title

MD

First Name

ERIC

Middle

JAY

Last Name

GOLDENBERG

Business Name

ERIC JAY GOLDENBERG MD

Original Issue Date

11/03/2017

Effective Date

11/03/2017

Expiration Date

09/30/2020

State

IN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

N

LastModifiedDate

01/14/2021