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 2024-02-24 09:10:26 UTC
LAST UPDATED 2024-02-24 09:10:26 UTC
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