Indiana
Professional Licensing Agency
Matthew Kevin Nickerson
Controlled Substance Registration-Osteopathic Physician
License number
02001698B
Date granted
12/07/1995
Date expires
06/30/2001
Class
Controlled Substance Registration-Osteopathic Physician
Status
Expired
Address
ST MARGARET MERCY NORTH EMER DEPT, 5454 HOHMAN AVENUE, HAMMOND IN 46320
indianalicensing.org
ID 5802731
LAST UPDATED 2024-03-14 21:08:29 UTC
LAST UPDATED 2024-03-14 21:08:29 UTC
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