License holder summary

Brent Michael Wiersema is a Controlled Substance Registration-Osteopathic Physician licensed to practice in Indiana. The address on file for Brent Michael Wiersema is OrthoIndy, 1801 N. Senate Blvd., Ste 200, Indianapolis IN 46202. This licensed professional license is not current. The license was granted 04/05/2004 and expired on 06/30/2007.

Indiana

Professional Licensing Agency

Brent Michael Wiersema
Controlled Substance Registration-Osteopathic Physician
License number
02002771B
Date granted
04/05/2004
Date expires
06/30/2007
Class
Controlled Substance Registration-Osteopathic Physician
Status
Expired
Address
OrthoIndy, 1801 N. Senate Blvd., Ste 200, Indianapolis IN 46202
indianalicensing.org
ID 5803916
LAST UPDATED 2024-03-31 18:36:50 UTC

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