Indiana
Professional Licensing Agency
RAYMOND BRIAN WALLACE
Controlled Substance Registration-Osteopathic Physician
License number
02001702B
Date granted
12/07/1995
Date expires
06/30/1999
Class
Controlled Substance Registration-Osteopathic Physician
Status
Expired
Address
ST MARGARET MERCY NORTH EMER DEPT, 5454 HOHMAN AVENUE, HAMMOND IN 46320
indianalicensing.org
ID 5802805
LAST UPDATED 2026-04-25 21:58:06 UTC
LAST UPDATED 2026-04-25 21:58:06 UTC
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