License holder summary

Jenelle Lea Justak is a Controlled Substance Registration-Osteopathic Physician licensed to practice in Indiana. The address on file for Jenelle Lea Justak is Deaconess Clinic- Pediatrics, 4111 Gateway Blvd, Newburgh IN 47630. This licensed professional license is current. The license was granted 09/12/2003 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Jenelle Lea Justak
Controlled Substance Registration-Osteopathic Physician
License number
02002672B
Date granted
09/12/2003
Date expires
10/31/2015
Class
Controlled Substance Registration-Osteopathic Physician
Status
Active
Address
Deaconess Clinic- Pediatrics, 4111 Gateway Blvd, Newburgh IN 47630
indianalicensing.org
ID 5810732
LAST UPDATED 2024-02-02 06:36:49 UTC

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