Indiana
Professional Licensing Agency
Jung Il Park
Controlled Substance Registration - Physician
License number
01032400B
Date granted
03/31/1986
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
9305 Calumet Avenue, Suite A 2, Munster IN 46321
indianalicensing.org
ID 5900712
LAST UPDATED 2024-04-27 23:31:53 UTC
LAST UPDATED 2024-04-27 23:31:53 UTC
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