License holder summary

Jerry L Mackel is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Jerry L Mackel is 7601 West Jefferson Blvd, P O Box 2526, Fort Wayne IN 46801. This licensed professional license is current. The license was granted 02/28/1986 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Jerry L Mackel
Controlled Substance Registration - Physician
License number
01023349B
Date granted
02/28/1986
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
7601 West Jefferson Blvd, P O Box 2526, Fort Wayne IN 46801
indianalicensing.org
ID 5853640
LAST UPDATED 2024-03-27 11:52:53 UTC

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