JACK WAYNE MILLER

Controlled Substance Registration - Physician

Indiana  01041752B   Expired

This Indiana license was held by JACK WAYNE MILLER. The license is no longer active. It was granted on 07/29/1993 and expired on 06/30/1997

LICENSE DETAILS

  • License Number: 01041752B
  • Category: CSR-Physician
  • Status: Expired
  • Date Granted: 07/29/1993 (almost 33 years ago)
  • Expiry Date: 06/30/1997 (almost 29 years ago)

LOCATIONS

A Address

PEDIATRIC ADVOCATES DR NEIL STALKER, 285 W 12TH ST, PERU IN 46970