ANNETTE G BURST

Controlled Substance Registration - Physician

Indiana  01023829B   Expired

This Indiana license was held by ANNETTE G BURST. The license is no longer active. It was granted on 02/14/2000 and expired on 06/30/2007

LICENSE DETAILS

  • License Number: 01023829B
  • Category: CSR-Physician
  • Status: Expired
  • Date Granted: 02/14/2000 (over 26 years ago)
  • Expiry Date: 06/30/2007 (about 19 years ago)

LOCATIONS

A Address

10509 OAK TRAIL, Fort Wayne IN 46845