License holder summary

Richard K. Niccum is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Richard K. Niccum is 3460 NORTH STATE ROAD 109, COLUMBIA CITY IN 46725. This licensed professional license is current. The license was granted 07/03/1989 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Richard K. Niccum
Controlled Substance Registration - Physician
License number
01037769B
Date granted
07/03/1989
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
3460 NORTH STATE ROAD 109, COLUMBIA CITY IN 46725
indianalicensing.org
ID 5835670
LAST UPDATED 2024-04-21 21:07:56 UTC

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