License holder summary

TAIS V CRAWFORD is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for TAIS V CRAWFORD is ST MARYS CONVENIENT CARE EASTSIDE CLIN, 10444 STREET ROAD 66, NEWBURGH IN 47630. This licensed professional license is not current. The license was granted 12/03/1999 and expired on 06/30/2001.

Indiana

Professional Licensing Agency

TAIS V CRAWFORD
Controlled Substance Registration - Physician
License number
01051774B
Date granted
12/03/1999
Date expires
06/30/2001
Class
Controlled Substance Registration - Physician
Status
Expired
Address
ST MARYS CONVENIENT CARE EASTSIDE CLIN, 10444 STREET ROAD 66, NEWBURGH IN 47630
indianalicensing.org
ID 5906404
LAST UPDATED 2024-04-23 10:48:41 UTC

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