License holder summary

Theodore B. Jefferson is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Theodore B. Jefferson is Saint Anthony Memorial Health Center, 301 West Homer Street, Michigan City IN 46360. This licensed professional license is not current. The license was granted 11/03/2009 and expired on 10/31/2013.

Indiana

Professional Licensing Agency

Theodore B. Jefferson
Controlled Substance Registration - Physician
License number
01067458B
Date granted
11/03/2009
Date expires
10/31/2013
Class
Controlled Substance Registration - Physician
Status
Expired
Address
Saint Anthony Memorial Health Center, 301 West Homer Street, Michigan City IN 46360
indianalicensing.org
ID 5893797
LAST UPDATED 2024-02-28 14:37:07 UTC

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