License holder summary

Samuel Lyle Graham, III is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Samuel Lyle Graham, III is MEDICAL STAFF OFFICE, 1220 MISSOURI AVENUE, JEFFERSONVILLE IN 47130. This licensed professional license is not current. The license was granted 09/24/1985 and expired on 06/30/2011.

Indiana

Professional Licensing Agency

Samuel Lyle Graham, III
Controlled Substance Registration - Physician
License number
01027250B
Date granted
09/24/1985
Date expires
06/30/2011
Class
Controlled Substance Registration - Physician
Status
Retired
Address
MEDICAL STAFF OFFICE, 1220 MISSOURI AVENUE, JEFFERSONVILLE IN 47130
indianalicensing.org
ID 5874223
LAST UPDATED 2024-02-15 09:46:55 UTC

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