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
LAST UPDATED 2024-04-06 15:12:23 UTC
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