Edward Lee Paul Shackleford
Controlled Substance Registration-Osteopathic Physician
Indiana 02001705B Expired
This Indiana license was held by Edward Lee Paul Shackleford. The license is no longer active. It was granted on 12/07/1995 and expired on 06/30/2001
LICENSE DETAILS
- License Number: 02001705B
- Category: CSR-Osteopathic Physician
- Status: Expired
- Date Granted: 12/07/1995 (over 28 years ago)
- Expiry Date: 06/30/2001 (almost 23 years ago)
LOCATIONS
A Address
St. Margaret Mercy North Emergency Dept., 5454 Hohman Avenue, Hammond IN 46320