License holder summary

Wylie Craig de Vera is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Wylie Craig de Vera is MedExpress, 1010 S Reed Road, Kokomo IN 46901. This licensed professional license is current. The license was granted 05/13/2013 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Wylie Craig de Vera
Controlled Substance Registration - Physician
License number
01071947B
Date granted
05/13/2013
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
MedExpress, 1010 S Reed Road, Kokomo IN 46901
indianalicensing.org
ID 5877562
LAST UPDATED 2024-02-23 15:20:47 UTC

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