Indiana
Professional Licensing Agency
DIRK THOMAS PRUIS
Controlled Substance Registration - Physician
License number
01030414B
Date granted
10/31/1985
Date expires
06/30/1991
Class
Controlled Substance Registration - Physician
Status
Expired
Address
1380 CHESTER BLVD, RICHMOND IN 47374
indianalicensing.org
ID 5912812
LAST UPDATED 2024-04-22 21:57:35 UTC
LAST UPDATED 2024-04-22 21:57:35 UTC
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