License holder summary

VICKIE JEAN PARK is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for VICKIE JEAN PARK is 1220 MISSOURI AVE, JEFFERSONVILLE IN 47130. This licensed professional license is not current. The license was granted 06/21/1984 and expired on 08/31/1985.

Indiana

Professional Licensing Agency

VICKIE JEAN PARK
Controlled Substance Registration - Physician
License number
01033512B
Date granted
06/21/1984
Date expires
08/31/1985
Class
Controlled Substance Registration - Physician
Status
Expired
Address
1220 MISSOURI AVE, JEFFERSONVILLE IN 47130
indianalicensing.org
ID 5874549
LAST UPDATED 2024-04-20 21:26:34 UTC

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