License holder summary

PAUL DETRISAC is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for PAUL DETRISAC is ST JOSEPH MED CTR ATTN KAREN VANDEPUTTE, 801 EAST LASALLE PO BOX 1935, SOUTH BEND IN 46634. This licensed professional license is current. The license was granted 04/30/1985 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

PAUL DETRISAC
Controlled Substance Registration - Physician
License number
01032411B
Date granted
04/30/1985
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
ST JOSEPH MED CTR ATTN KAREN VANDEPUTTE, 801 EAST LASALLE PO BOX 1935, SOUTH BEND IN 46634
indianalicensing.org
ID 5921883
LAST UPDATED 2024-04-07 00:44:10 UTC

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