License holder summary

Jason Y S Park is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Jason Y S Park is 3702 SOUTH FOURTH STREET, TERRE HAUTE IN 47802. This licensed professional license is not current. The license was granted 06/02/1986 and expired on 06/30/2001.

Indiana

Professional Licensing Agency

Jason Y S Park
Controlled Substance Registration - Physician
License number
01024742B
Date granted
06/02/1986
Date expires
06/30/2001
Class
Controlled Substance Registration - Physician
Status
Expired
Address
3702 SOUTH FOURTH STREET, TERRE HAUTE IN 47802
indianalicensing.org
ID 5925557
LAST UPDATED 2024-04-06 15:12:23 UTC

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