Chung Ja Kim
Controlled Substance Registration - Physician
Indiana 01030903B Expired
This Indiana license was held by Chung Ja Kim. The license is no longer active. It was granted on 07/31/1986 and expired on 06/30/2011
LICENSE DETAILS
- License Number: 01030903B
- Category: CSR-Physician
- Status: Expired
- Date Granted: 07/31/1986 (almost 39 years ago)
- Expiry Date: 06/30/2011 (almost 14 years ago)
LOCATIONS
A Address
2000 Roosevelt Road Suite 104, Valparaiso IN 46383