License holder summary

LIDIA STANA ILCUS is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for LIDIA STANA ILCUS is 712 BURGESS AVENUE LANE, RISING SUN IN 47040. This licensed professional license is not current. The license was granted 03/27/1997 and expired on 06/30/2001.

Indiana

Professional Licensing Agency

LIDIA STANA ILCUS
Controlled Substance Registration - Physician
License number
01044352B
Date granted
03/27/1997
Date expires
06/30/2001
Class
Controlled Substance Registration - Physician
Status
Expired
Address
712 BURGESS AVENUE LANE, RISING SUN IN 47040
indianalicensing.org
ID 5914833
LAST UPDATED 2024-03-10 01:21:15 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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