License holder summary

GARY MICHAEL PODHAISKY is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for GARY MICHAEL PODHAISKY is 3506 SOUTH LAFOUNTAIN STREET, KOKOMO IN 46902. This licensed professional license is not current. The license was granted 04/24/1997 and expired on 06/30/2001.

Indiana

Professional Licensing Agency

GARY MICHAEL PODHAISKY
Controlled Substance Registration - Physician
License number
01046563B
Date granted
04/24/1997
Date expires
06/30/2001
Class
Controlled Substance Registration - Physician
Status
Expired
Address
3506 SOUTH LAFOUNTAIN STREET, KOKOMO IN 46902
indianalicensing.org
ID 5876112
LAST UPDATED 2024-02-20 23:16:17 UTC

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