BRIAN DAVE DIETERLE

Controlled Substance Registration - Physician

Indiana  01040638B   Expired

This Indiana license was held by BRIAN DAVE DIETERLE. The license is no longer active. It was granted on 08/03/1992 and expired on 06/30/1995

LICENSE DETAILS

  • License Number: 01040638B
  • Category: CSR-Physician
  • Status: Expired
  • Date Granted: 08/03/1992 (almost 34 years ago)
  • Expiry Date: 06/30/1995 (almost 31 years ago)

LOCATIONS

A Address

100 N 15TH ST, RICHMOND IN 47374