License holder summary

JERRY MAYNE WEIDA is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for JERRY MAYNE WEIDA is 3005 GREENBUSH STREET, LAFAYETTE IN 47904. This licensed professional license is current. The license was granted 02/28/1986 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

JERRY MAYNE WEIDA
Controlled Substance Registration - Physician
License number
01020537B
Date granted
02/28/1986
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
3005 GREENBUSH STREET, LAFAYETTE IN 47904
indianalicensing.org
ID 5879779
LAST UPDATED 2021-06-12 20:25:25 UTC

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