Indiana
Professional Licensing Agency
Alfred Russell Heasty, SR
Controlled Substance Registration - Physician
License number
01020944B
Date granted
02/28/1986
Date expires
06/30/1995
Class
Controlled Substance Registration - Physician
Status
Expired
Address
610 MAIN STREET, WEST LAFAYETTE IN 47906
indianalicensing.org
ID 5933780
LAST UPDATED 2024-04-28 18:10:13 UTC
LAST UPDATED 2024-04-28 18:10:13 UTC
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