Indiana
Professional Licensing Agency
Chung Ja Kim
Controlled Substance Registration - Physician
License number
01030903B
Date granted
07/31/1986
Date expires
06/30/2011
Class
Controlled Substance Registration - Physician
Status
Expired
Address
2000 Roosevelt Road Suite 104, Valparaiso IN 46383
indianalicensing.org
ID 5928273
LAST UPDATED 2024-03-10 00:46:17 UTC
LAST UPDATED 2024-03-10 00:46:17 UTC
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