Indiana
Professional Licensing Agency
Kerry Mark Keaffaber
Controlled Substance Registration - Physician
License number
01033783B
Date granted
05/31/1985
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Shipshewana Family Medicine, 450 E Country Lane, Shipshewana IN 46565
indianalicensing.org
ID 5920332
LAST UPDATED 2024-03-02 19:31:02 UTC
LAST UPDATED 2024-03-02 19:31:02 UTC
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