Indiana
Professional Licensing Agency
WAYNE ALBERT CROCKETT
Controlled Substance Registration - Physician
License number
01016729B
Date granted
11/30/1984
Date expires
06/30/2003
Class
Controlled Substance Registration - Physician
Status
Expired
Address
2723 South 7th Street, Suite E, Terre Haute IN 47802
indianalicensing.org
ID 5926985
LAST UPDATED 2024-02-20 14:59:46 UTC
LAST UPDATED 2024-02-20 14:59:46 UTC
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