Indiana
Professional Licensing Agency
JACK GERALD WEINBAUM
Controlled Substance Registration - Physician
License number
01017558B
Date granted
05/05/1986
Date expires
06/30/1989
Class
Controlled Substance Registration - Physician
Status
Expired
Address
1505 N 7TH STREET, TERRE HAUTE IN 47808
indianalicensing.org
ID 5925450
LAST UPDATED 2024-03-27 19:26:20 UTC
LAST UPDATED 2024-03-27 19:26:20 UTC
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