License holder summary

MARK WISEN is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for MARK WISEN is 503 SOUTH BALLANTINE ROAD, Bloomington IN 47401. This licensed professional license is not current. The license was granted 10/31/1985 and expired on 06/30/2003.

Indiana

Professional Licensing Agency

MARK WISEN
Controlled Substance Registration - Physician
License number
01018906B
Date granted
10/31/1985
Date expires
06/30/2003
Class
Controlled Substance Registration - Physician
Status
Expired
Address
503 SOUTH BALLANTINE ROAD, Bloomington IN 47401
indianalicensing.org
ID 5825231
LAST UPDATED 2024-04-13 23:46:29 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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