Fawale Modupe Fadare

Nursing Board - Csr Prescriptive Authority

Indiana  70000156B   Expired

This Indiana license was held by Fawale Modupe Fadare. The license is no longer active. It was granted on 05/28/2004 and expired on 10/31/2011

LICENSE DETAILS

  • License Number: 70000156B
  • Category: CSR-Prescriptive Authority
  • Status: Expired
  • Date Granted: 05/28/2004 (almost 21 years ago)
  • Expiry Date: 10/31/2011 (over 13 years ago)

LOCATIONS

A Address

Grantblackford Mental Health, 505 Wabash Avenue, Marion IN 46952