TRUC TRUNG LY MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****27

NOT RENEWED

N

MD

TRUC

TRUNG

LY

TRUC TRUNG LY MD

07/29/2009

12/07/2015

07/31/2017

MISHAWAKA

IN

46545

INDIANA

PRACTITIONER

II III IV V

N

11/01/2017