Indiana
Professional Licensing Agency
Kent A. Kirk
Controlled Substance Registration - Physician
License number
01049520B
Date granted
09/24/1998
Date expires
06/30/2003
Class
Controlled Substance Registration - Physician
Status
Expired
Address
BRODERSEN WILLIAMS EYE INSTITUTE P C, 6850 HOHMAN AVE, HAMMOND IN 46324
indianalicensing.org
ID 5864404
LAST UPDATED 2024-03-20 00:41:12 UTC
LAST UPDATED 2024-03-20 00:41:12 UTC
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