License holder summary

John Levi Shively is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for John Levi Shively is LAFAYETTE ORTHOPAEDIC CLINIC INC, 1411 S CREASY LANE STE 200 PO BOX 4699, Lafayette IN 47903-4699. This licensed professional license is not current. The license was granted 01/31/1986 and expired on 06/30/2003.

Indiana

Professional Licensing Agency

John Levi Shively
Controlled Substance Registration - Physician
License number
01015281B
Date granted
01/31/1986
Date expires
06/30/2003
Class
Controlled Substance Registration - Physician
Status
Expired
Address
LAFAYETTE ORTHOPAEDIC CLINIC INC, 1411 S CREASY LANE STE 200 PO BOX 4699, Lafayette IN 47903-4699
indianalicensing.org
ID 5879903
LAST UPDATED 2024-04-19 20:48:28 UTC

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