License holder summary

Jerryl Johnson Simmons is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Jerryl Johnson Simmons is FPN on Broadway, 9470 Broadway St., Crown Point IN 46307. This licensed professional license is current. The license was granted 04/22/2008 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Jerryl Johnson Simmons
Controlled Substance Registration - Physician
License number
01038165C
Date granted
04/22/2008
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
FPN on Broadway, 9470 Broadway St., Crown Point IN 46307
indianalicensing.org
ID 5841191
LAST UPDATED 2024-04-02 09:56:04 UTC

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