Indiana
Professional Licensing Agency
WALLACE CLARK HILL
Controlled Substance Registration - Physician
License number
01018236B
Date granted
03/31/1986
Date expires
06/30/2001
Class
Controlled Substance Registration - Physician
Status
Expired
Address
248 SOUTH HAWTHORNE PLACE, SOUTH BEND IN 46617
indianalicensing.org
ID 5922565
LAST UPDATED 2024-04-23 01:29:22 UTC
LAST UPDATED 2024-04-23 01:29:22 UTC
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