License holder summary

SUSAN MARIE KSIAZEK is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for SUSAN MARIE KSIAZEK is 5541 WHITE HALL WAY, CARMEL IN 46033. This licensed professional license is not current. The license was granted 02/01/1995 and expired on 06/30/2003.

Indiana

Professional Licensing Agency

SUSAN MARIE KSIAZEK
Controlled Substance Registration - Physician
License number
01043421B
Date granted
02/01/1995
Date expires
06/30/2003
Class
Controlled Substance Registration - Physician
Status
Expired
Address
5541 WHITE HALL WAY, CARMEL IN 46033
indianalicensing.org
ID 5832102
LAST UPDATED 2024-03-10 07:27:48 UTC

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