License holder summary

Samuel Jackson Drake is a Controlled Substance Registration-Osteopathic Physician licensed to practice in Indiana. The address on file for Samuel Jackson Drake is 19978 ROOSEVELT, SOUTH BEND IN 46614. This licensed professional license is not current. The license was granted 10/31/1985 and expired on 06/30/2001.

Indiana

Professional Licensing Agency

Samuel Jackson Drake
Controlled Substance Registration-Osteopathic Physician
License number
02000065B
Date granted
10/31/1985
Date expires
06/30/2001
Class
Controlled Substance Registration-Osteopathic Physician
Status
Expired
Address
19978 ROOSEVELT, SOUTH BEND IN 46614
indianalicensing.org
ID 5813684
LAST UPDATED 2024-05-12 06:50:59 UTC

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