License holder summary

John Raphael Kim is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for John Raphael Kim is 6119 West Jefferson Blvd, Fort Wayne IN 46804. This licensed professional license is not current. The license was granted 06/30/1994 and expired on 10/31/2013.

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

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