David J. Janicki

Controlled Substance Registration - Physician

Indiana  01024050B   Active

This Indiana license is held by David J. Janicki. The license is currently active. It was granted on 06/30/1986 and expired on 10/31/2015

LICENSE DETAILS

  • License Number: 01024050B
  • Category: CSR-Physician
  • Status: Active
  • Date Granted: 06/30/1986 (almost 39 years ago)
  • Expiry Date: 10/31/2015 (over 9 years ago)

LOCATIONS

A Address

PROVIDENCE MEDICAL GROUP, 2723 South Seventh Street, Suite D, Terre Haute IN 47802