License holder summary

Kenneth Maurice Sample is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Kenneth Maurice Sample is 2100 Market Street, Suite 200, Charlestown IN 47111. This licensed professional license is not current. The license was granted 10/17/2000 and expired on 06/30/2005.

Indiana

Professional Licensing Agency

Kenneth Maurice Sample
Controlled Substance Registration - Physician
License number
01053054B
Date granted
10/17/2000
Date expires
06/30/2005
Class
Controlled Substance Registration - Physician
Status
Expired
Address
2100 Market Street, Suite 200, Charlestown IN 47111
indianalicensing.org
ID 5833147
LAST UPDATED 2024-03-21 08:09:23 UTC

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