License holder summary

Mark Jay Mc Gillem is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Mark Jay Mc Gillem is 615 N Michigan Street, Suite 703, South Bend IN 46601. This licensed professional license is not current. The license was granted 08/09/1999 and expired on 10/31/2013.

Indiana

Professional Licensing Agency

Mark Jay Mc Gillem
Controlled Substance Registration - Physician
License number
01051194B
Date granted
08/09/1999
Date expires
10/31/2013
Class
Controlled Substance Registration - Physician
Status
Expired
Address
615 N Michigan Street, Suite 703, South Bend IN 46601
indianalicensing.org
ID 5921642
LAST UPDATED 2024-05-01 03:13:41 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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