License holder summary

Jerry G. Back is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Jerry G. Back is 7002 JOHNSON ROAD, LAPORTE IN 46350. This licensed professional license is not current. The license was granted 09/28/1989 and expired on 06/30/2009.

Indiana

Professional Licensing Agency

Jerry G. Back
Controlled Substance Registration - Physician
License number
01037977B
Date granted
09/28/1989
Date expires
06/30/2009
Class
Controlled Substance Registration - Physician
Status
Expired
Address
7002 JOHNSON ROAD, LAPORTE IN 46350
indianalicensing.org
ID 5878062
LAST UPDATED 2026-05-06 22:16:55 UTC

This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.

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