License holder summary

STACEY J CLARKE is a Controlled Substance Registration - Podiatrist licensed to practice in Indiana. The address on file for STACEY J CLARKE is CAYLOR NICKEL MEDICAL CENTER, ONE CAYLOR NICKEL SQUARE, BLUFFTON IN 46714. This licensed professional license is not current. The license was granted 07/20/1994 and expired on 06/30/2001.

Indiana

Professional Licensing Agency

STACEY J CLARKE
Controlled Substance Registration - Podiatrist
License number
07000790B
Date granted
07/20/1994
Date expires
06/30/2001
Class
Controlled Substance Registration - Podiatrist
Status
Expired
Address
CAYLOR NICKEL MEDICAL CENTER, ONE CAYLOR NICKEL SQUARE, BLUFFTON IN 46714
indianalicensing.org
ID 8429771
LAST UPDATED 2024-04-22 14:33:36 UTC

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