Indiana
Professional Licensing Agency
SUSAN MARIE KSIAZEK
Controlled Substance Registration - Physician
License number
01043421B
Date granted
02/01/1995
Date expires
06/30/2003
Class
Controlled Substance Registration - Physician
Status
Expired
Address
5541 WHITE HALL WAY, CARMEL IN 46033
indianalicensing.org
ID 5832102
LAST UPDATED 2024-03-28 13:41:39 UTC
LAST UPDATED 2024-03-28 13:41:39 UTC
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