License holder summary

Maria Mikaela Petrick is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Maria Mikaela Petrick is Family Allergy and Asthma, 508 North Broadway, Madison IN 47250-3308. This licensed professional license is current. The license was granted 05/11/2007 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Maria Mikaela Petrick
Controlled Substance Registration - Physician
License number
01063403B
Date granted
05/11/2007
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Family Allergy and Asthma, 508 North Broadway, Madison IN 47250-3308
indianalicensing.org
ID 5886998
LAST UPDATED 2024-03-08 02:10:04 UTC

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