DAVID JACKSON DIETZ
Controlled Substance Registration - Physician
Indiana 01019749B Expired
This Indiana license was held by DAVID JACKSON DIETZ. The license is no longer active. It was granted on 10/31/1984 and expired on 06/30/2001
LICENSE DETAILS
- License Number: 01019749B
- Category: CSR-Physician
- Status: Expired
- Date Granted: 10/31/1984 (over 40 years ago)
- Expiry Date: 06/30/2001 (almost 24 years ago)
LOCATIONS
A Address
2810 ETHEL AVENUE, MUNCIE IN 47304