License holder summary

Ricky Johnson is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Ricky Johnson is ST JOSEPH HOSPITAL, 1915 LAKE AVENUE BOX 670, PLYMOUTH IN 46563. This licensed professional license is not current. The license was granted 10/09/1991 and expired on 06/30/1995.

Indiana

Professional Licensing Agency

Ricky Johnson
Controlled Substance Registration - Physician
License number
01039638B
Date granted
10/09/1991
Date expires
06/30/1995
Class
Controlled Substance Registration - Physician
Status
Expired
Address
ST JOSEPH HOSPITAL, 1915 LAKE AVENUE BOX 670, PLYMOUTH IN 46563
indianalicensing.org
ID 5910736
LAST UPDATED 2024-04-17 00:00:32 UTC

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