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 The license is no longer active.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