Indiana
Professional Licensing Agency
Brian D. Dierckman
Controlled Substance Registration - Physician
License number
01071470B
Date granted
07/24/2012
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
American Health Network, 5250 East US 36, Avon IN 46123
indianalicensing.org
ID 5819936
LAST UPDATED 2024-04-03 10:59:04 UTC
LAST UPDATED 2024-04-03 10:59:04 UTC
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