Frederick Richard Stack
Controlled Substance Registration - Physician
Indiana 01042051C Expired
This Indiana license was held by Frederick Richard Stack. The license is no longer active. It was granted on 12/28/1999 and expired on 06/30/2001
LICENSE DETAILS
- License Number: 01042051C
- Category: CSR-Physician
- Status: Expired
- Date Granted: 12/28/1999 (over 25 years ago)
- Expiry Date: 06/30/2001 (almost 24 years ago)
LOCATIONS
A Address
1504 TANGLEWOOD LANE, NASHVILLE IN 47448