Indiana
Professional Licensing Agency
Jack C. Moore, II
Controlled Substance Registration - Physician
License number
01069727B
Date granted
06/07/2011
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Charlestown - Clark Medical Group, 11500 Street Road 62, Charlestown IN 47111
indianalicensing.org
ID 5833053
LAST UPDATED 2024-02-14 17:47:53 UTC
LAST UPDATED 2024-02-14 17:47:53 UTC
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