Indiana
Professional Licensing Agency
Fredrick Hubert Wallisch
Controlled Substance Registration - Physician
License number
01059213B
Date granted
05/28/2004
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Deaconess Clinic, 4015 Gateway Blvd. Third Floor, Newburgh IN 47630
indianalicensing.org
ID 5905564
LAST UPDATED 2024-02-09 02:48:05 UTC
LAST UPDATED 2024-02-09 02:48:05 UTC
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