Indiana
Professional Licensing Agency
Ahmad S. Khraisat
Controlled Substance Registration - Physician
License number
01057872B
Date granted
07/15/2003
Date expires
06/30/2007
Class
Controlled Substance Registration - Physician
Status
Expired
Address
Tatum Family Health Center, 1619 West 5th Avenue, Gary IN 46404
indianalicensing.org
ID 5856087
LAST UPDATED 2024-04-13 12:32:55 UTC
LAST UPDATED 2024-04-13 12:32:55 UTC
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