Indiana
Professional Licensing Agency
Jerrold Arthur Van Dyke
Controlled Substance Registration - Physician
License number
01034819B
Date granted
12/12/1985
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Radiology, Inc., 620 Edison Road, Suite 110, Mishawaka IN 46545
indianalicensing.org
ID 5895200
LAST UPDATED 2024-02-27 15:06:06 UTC
LAST UPDATED 2024-02-27 15:06:06 UTC
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