Alfred Russell Heasty, SR
Controlled Substance Registration - Physician
Indiana 01020944B Expired
This Indiana license was held by Alfred Russell Heasty, SR. The license is no longer active. It was granted on 02/28/1986 and expired on 06/30/1995
LICENSE DETAILS
- License Number: 01020944B
- Category: CSR-Physician
- Status: Expired
- Date Granted: 02/28/1986 (over 40 years ago)
- Expiry Date: 06/30/1995 (about 31 years ago)
LOCATIONS
A Address
610 MAIN STREET, WEST LAFAYETTE IN 47906