License holder summary

JACK WAYNE MILLER is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for JACK WAYNE MILLER is PEDIATRIC ADVOCATES DR NEIL STALKER, 285 W 12TH ST, PERU IN 46970. This licensed professional license is not current. The license was granted 07/29/1993 and expired on 06/30/1997.

Indiana

Professional Licensing Agency

JACK WAYNE MILLER
Controlled Substance Registration - Physician
License number
01041752B
Date granted
07/29/1993
Date expires
06/30/1997
Class
Controlled Substance Registration - Physician
Status
Expired
Address
PEDIATRIC ADVOCATES DR NEIL STALKER, 285 W 12TH ST, PERU IN 46970
indianalicensing.org
ID 5909480
LAST UPDATED 2024-05-03 23:38:31 UTC

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