Indiana
Professional Licensing Agency
Jerry D. Becker
Controlled Substance Registration - Physician
License number
01019382B
Date granted
04/30/1986
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
4266 Ashbury Parke Dr, Newburgh IN 47630
indianalicensing.org
ID 5905733
LAST UPDATED 2024-03-29 19:38:38 UTC
LAST UPDATED 2024-03-29 19:38:38 UTC
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