License holder summary

BRIAN E STAKEM is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for BRIAN E STAKEM is 2600 GREENBUSH STREET, LAFAYETTE IN 47904. This licensed professional license is not current. The license was granted 01/31/1986 and expired on 06/30/1999.

Indiana

Professional Licensing Agency

BRIAN E STAKEM
Controlled Substance Registration - Physician
License number
01023696B
Date granted
01/31/1986
Date expires
06/30/1999
Class
Controlled Substance Registration - Physician
Status
Expired
Address
2600 GREENBUSH STREET, LAFAYETTE IN 47904
indianalicensing.org
ID 5878867
LAST UPDATED 2024-03-18 12:04:28 UTC

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