License holder summary

Jesse Nicole Clark is a Controlled Substance Registration-Osteopathic Physician licensed to practice in Indiana. The address on file for Jesse Nicole Clark is 10122 E 10th St Suite #100, Indianapolis IN 46229. This licensed professional license is current. The license was granted 08/16/2012 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Jesse Nicole Clark
Controlled Substance Registration-Osteopathic Physician
License number
02004005B
Date granted
08/16/2012
Date expires
10/31/2015
Class
Controlled Substance Registration-Osteopathic Physician
Status
Active
Address
10122 E 10th St Suite #100, Indianapolis IN 46229
indianalicensing.org
ID 5804742
LAST UPDATED 2024-05-08 05:20:08 UTC

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