Daniel L. Icenogle
Controlled Substance Registration - Physician
Indiana 01031829B Expired
This Indiana license was held by Daniel L. Icenogle. The license is no longer active. It was granted on 07/31/1983 and expired on 06/30/1989
LICENSE DETAILS
- License Number: 01031829B
- Category: CSR-Physician
- Status: Expired
- Date Granted: 07/31/1983 (almost 41 years ago)
- Expiry Date: 06/30/1989 (almost 35 years ago)
LOCATIONS
A Address
2600 GREENBUSH STREET, LAFAYETTE IN 47904