Indiana
Professional Licensing Agency
David J. Janicki
Controlled Substance Registration - Physician
License number
01024050B
Date granted
06/30/1986
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
PROVIDENCE MEDICAL GROUP, 2723 South Seventh Street, Suite D, Terre Haute IN 47802
indianalicensing.org
ID 5924929
LAST UPDATED 2024-03-20 09:24:49 UTC
LAST UPDATED 2024-03-20 09:24:49 UTC
This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.