License holder summary

MARK RICHARD POLAK is a Controlled Substance Registration-Osteopathic Physician licensed to practice in Indiana. The address on file for MARK RICHARD POLAK is MEDICAL DEPT CODE 12, NAVAL SURFACE WARFARE CENTER, CRANE IN 47522. This licensed professional license is not current. The license was granted 07/30/1992 and expired on 06/30/1995.

Indiana

Professional Licensing Agency

MARK RICHARD POLAK
Controlled Substance Registration-Osteopathic Physician
License number
02001349B
Date granted
07/30/1992
Date expires
06/30/1995
Class
Controlled Substance Registration-Osteopathic Physician
Status
Expired
Address
MEDICAL DEPT CODE 12, NAVAL SURFACE WARFARE CENTER, CRANE IN 47522
indianalicensing.org
ID 5797391
LAST UPDATED 2026-06-11 04:01:39 UTC

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