DIRK THOMAS PRUIS

Controlled Substance Registration - Physician

Indiana  01030414B   Expired

This Indiana license was held by DIRK THOMAS PRUIS. The license is no longer active. It was granted on 10/31/1985 and expired on 06/30/1991

LICENSE DETAILS

  • License Number: 01030414B
  • Category: CSR-Physician
  • Status: Expired
  • Date Granted: 10/31/1985 (over 39 years ago)
  • Expiry Date: 06/30/1991 (almost 34 years ago)

LOCATIONS

A Address

1380 CHESTER BLVD, RICHMOND IN 47374