License holder summary

SUSAN JANE SHEPPARD is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for SUSAN JANE SHEPPARD is 12 INDEPENDENCE SQUARE, Bloomington IL 61704. This licensed professional license is not current. The license was granted 06/26/1997 and expired on 06/30/2003.

Indiana

Professional Licensing Agency

SUSAN JANE SHEPPARD
Controlled Substance Registration - Physician
License number
01047028B
Date granted
06/26/1997
Date expires
06/30/2003
Class
Controlled Substance Registration - Physician
Status
Expired
Address
12 INDEPENDENCE SQUARE, Bloomington IL 61704
indianalicensing.org
ID 5825861
LAST UPDATED 2024-01-30 03:26:02 UTC

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