Beverly Trent Maxam

Controlled Substance Registration - Physician

Indiana  01015987B   Expired

This Indiana license was held by Beverly Trent Maxam. The license is no longer active. It was granted on 02/28/1986 and expired on 10/31/2013

LICENSE DETAILS

  • License Number: 01015987B
  • Category: CSR-Physician
  • Status: Expired
  • Date Granted: 02/28/1986 (over 38 years ago)
  • Expiry Date: 10/31/2013 (over 10 years ago)

LOCATIONS

A Address

11036 Lincoln Trails Drive, Indianapolis IN 46236