License holder summary

Krista De Ann Pellicore is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Krista De Ann Pellicore is 219 W Washington St, Rensselaer IN 47978. This licensed professional license is current. The license was granted 05/12/2003 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Krista De Ann Pellicore
Controlled Substance Registration - Physician
License number
01057388B
Date granted
05/12/2003
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
219 W Washington St, Rensselaer IN 47978
indianalicensing.org
ID 5912400
LAST UPDATED 2024-04-06 00:05:23 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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