License holder summary

Keith W. Ivens is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Keith W. Ivens is 727 MOON ROAD, PLAINFIELD IN 46168. This licensed professional license is not current. The license was granted 08/31/1995 and expired on 06/30/1999.

Indiana

Professional Licensing Agency

Keith W. Ivens
Controlled Substance Registration - Physician
License number
01044224C
Date granted
08/31/1995
Date expires
06/30/1999
Class
Controlled Substance Registration - Physician
Status
Expired
Address
727 MOON ROAD, PLAINFIELD IN 46168
indianalicensing.org
ID 5910152
LAST UPDATED 2026-03-15 19:14:04 UTC

This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.

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