License holder summary

Otto W. Wickstrom, Jr. is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Otto W. Wickstrom, Jr. is 2360 NORTH NATIONAL RD, COLUMBUS IN 47201. This licensed professional license is not current. The license was granted 09/30/1986 and expired on 06/30/2009.

Indiana

Professional Licensing Agency

Otto W. Wickstrom, Jr.
Controlled Substance Registration - Physician
License number
01018161B
Date granted
09/30/1986
Date expires
06/30/2009
Class
Controlled Substance Registration - Physician
Status
Expired
Address
2360 NORTH NATIONAL RD, COLUMBUS IN 47201
indianalicensing.org
ID 5836962
LAST UPDATED 2024-02-04 11:32:19 UTC

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