License holder summary

Kim Waterfall is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Kim Waterfall is Ligonier Family Medicine, 1464 LINCOLNWAY SO P O BOX 293, LIGONIER IN 46767. This licensed professional license is not current. The license was granted 06/25/1996 and expired on 06/30/2009.

Indiana

Professional Licensing Agency

Kim Waterfall
Controlled Substance Registration - Physician
License number
01025471B
Date granted
06/25/1996
Date expires
06/30/2009
Class
Controlled Substance Registration - Physician
Status
Expired
Address
Ligonier Family Medicine, 1464 LINCOLNWAY SO P O BOX 293, LIGONIER IN 46767
indianalicensing.org
ID 5884489
LAST UPDATED 2024-02-24 04:59:18 UTC

This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.

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