ALICE E BLACK SCHAFFER

Controlled Substance Registration - Physician

Indiana  01022414B   Expired

This Indiana license was held by ALICE E BLACK SCHAFFER. The license is no longer active. It was granted on 08/22/1968 and expired on 06/30/1997

LICENSE DETAILS

  • License Number: 01022414B
  • Category: CSR-Physician
  • Status: Expired
  • Date Granted: 08/22/1968 (almost 58 years ago)
  • Expiry Date: 06/30/1997 (about 29 years ago)

LOCATIONS

A Address

4510 BLACKSTONE COURT, BLOOMINGTON IN 47408