Indiana
Professional Licensing Agency
John Raphael Kim
Controlled Substance Registration - Physician
License number
01042685B
Date granted
06/30/1994
Date expires
10/31/2013
Class
Controlled Substance Registration - Physician
Status
Retired
Address
6119 West Jefferson Blvd, Fort Wayne IN 46804
indianalicensing.org
ID 5853732
LAST UPDATED 2024-01-05 14:25:07 UTC
LAST UPDATED 2024-01-05 14:25:07 UTC
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