Indiana
Professional Licensing Agency
Jack C. Blackstone, Jr.
Controlled Substance Registration - Physician
License number
01025126B
Date granted
12/03/1996
Date expires
06/30/2005
Class
Controlled Substance Registration - Physician
Status
Expired
Address
PERRY COUNTY MEMORAIL HOSPITAL, 1 HOSPITAL ROAD, TELL CITY IN 47586
indianalicensing.org
ID 5924154
LAST UPDATED 2024-02-23 14:20:08 UTC
LAST UPDATED 2024-02-23 14:20:08 UTC
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