License holder summary

RUSSELL RAYMOND JAICKS is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for RUSSELL RAYMOND JAICKS is WHITE CITY MEMORIAL HOSP EMERGENCY RM, 1101 O CONNOR BLVD, MONTICELLO IN 47960. This licensed professional license is not current. The license was granted 04/27/1994 and expired on 06/30/1995.

Indiana

Professional Licensing Agency

RUSSELL RAYMOND JAICKS
Controlled Substance Registration - Physician
License number
01042428B
Date granted
04/27/1994
Date expires
06/30/1995
Class
Controlled Substance Registration - Physician
Status
Expired
Address
WHITE CITY MEMORIAL HOSP EMERGENCY RM, 1101 O CONNOR BLVD, MONTICELLO IN 47960
indianalicensing.org
ID 5896678
LAST UPDATED 2024-04-03 06:45:18 UTC

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