Indiana
Professional Licensing Agency
Mark Jeffrey Wade
Controlled Substance Registration - Physician
License number
01072019B
Date granted
01/02/2013
Date expires
10/31/2013
Class
Controlled Substance Registration - Physician
Status
Expired
Address
Countyline Medical Pavillion, 333 E County Line Road, Greenwood IN 46143
indianalicensing.org
ID 5862095
LAST UPDATED 2024-03-06 15:27:28 UTC
LAST UPDATED 2024-03-06 15:27:28 UTC
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