Indiana
Professional Licensing Agency
Dean Kim Park
Controlled Substance Registration - Physician
License number
01063363C
Date granted
06/16/2010
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Cancer Care Partners, 301 East Day Road, Mishawaka IN 46545
indianalicensing.org
ID 5894848
LAST UPDATED 2024-03-23 15:40:40 UTC
LAST UPDATED 2024-03-23 15:40:40 UTC
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