Indiana
Professional Licensing Agency
Yong Am Park
Controlled Substance Registration - Physician
License number
01044315B
Date granted
09/12/1995
Date expires
06/30/2003
Class
Controlled Substance Registration - Physician
Status
Expired
Address
1479 East 84th Place, Merrillville IN 46410
indianalicensing.org
ID 5891989
LAST UPDATED 2024-04-02 19:03:20 UTC
LAST UPDATED 2024-04-02 19:03:20 UTC
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