License holder summary

JACK L EISAMAN is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for JACK L EISAMAN is 389 EAST MORSCHES ROAD, COLUMBIA CITY IN 46725. This licensed professional license is not current. The license was granted 06/30/1986 and expired on 06/30/1999.

Indiana

Professional Licensing Agency

JACK L EISAMAN
Controlled Substance Registration - Physician
License number
01013174B
Date granted
06/30/1986
Date expires
06/30/1999
Class
Controlled Substance Registration - Physician
Status
Expired
Address
389 EAST MORSCHES ROAD, COLUMBIA CITY IN 46725
indianalicensing.org
ID 5835549
LAST UPDATED 2024-03-20 10:14:19 UTC

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