Indiana
Professional Licensing Agency
Kenneth Wayne Anderson
Controlled Substance Registration - Physician
License number
01023328B
Date granted
11/30/1978
Date expires
06/30/2007
Class
Controlled Substance Registration - Physician
Status
Expired
Address
Johanna Kicherer, 560 Golden Place, Lafayette IN 47905
indianalicensing.org
ID 5880090
LAST UPDATED 2024-04-23 05:51:51 UTC
LAST UPDATED 2024-04-23 05:51:51 UTC
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