Indiana
Professional Licensing Agency
Sung Jae Park
Controlled Substance Registration - Physician
License number
01051341B
Date granted
11/18/1999
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Kosciusko Family Healthcare, 2235 Dubois Dr., Warsaw IN 46580
indianalicensing.org
ID 5932959
LAST UPDATED 2024-04-07 13:21:15 UTC
LAST UPDATED 2024-04-07 13:21:15 UTC
This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.