License holder summary

Niki Moscandrew is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Niki Moscandrew is ST ANTHONY MEDICAL CTR DEPT OF PATHOLOGY, 1201 S MAIN STREET, CROWN POINT IN 46307. This licensed professional license is not current. The license was granted 10/05/1995 and expired on 06/30/2001.

Indiana

Professional Licensing Agency

Niki Moscandrew
Controlled Substance Registration - Physician
License number
01026812B
Date granted
10/05/1995
Date expires
06/30/2001
Class
Controlled Substance Registration - Physician
Status
Expired
Address
ST ANTHONY MEDICAL CTR DEPT OF PATHOLOGY, 1201 S MAIN STREET, CROWN POINT IN 46307
indianalicensing.org
ID 5841683
LAST UPDATED 2024-03-26 05:27:21 UTC

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