License holder summary

RONALD ANTHONY HICKOMBOTTOM is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for RONALD ANTHONY HICKOMBOTTOM is MISSIONARY HEALTH PARTNERS, 2250 GRANT AVE SUITE 201, GARY IN 46404. This licensed professional license is not current. The license was granted 10/28/1998 and expired on 06/30/2001.

Indiana

Professional Licensing Agency

RONALD ANTHONY HICKOMBOTTOM
Controlled Substance Registration - Physician
License number
01049688B
Date granted
10/28/1998
Date expires
06/30/2001
Class
Controlled Substance Registration - Physician
Status
Expired
Address
MISSIONARY HEALTH PARTNERS, 2250 GRANT AVE SUITE 201, GARY IN 46404
indianalicensing.org
ID 5857463
LAST UPDATED 2024-05-11 00:46:11 UTC

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