JAY POLHEMUS
Controlled Substance Registration - Physician
Indiana 01025432B Suspended
This Indiana license was held by JAY POLHEMUS. The license is no longer active. It was granted on 05/18/1987 and expired on 06/30/1995
LICENSE DETAILS
- License Number: 01025432B
- Category: CSR-Physician
- Status: Suspended
- Date Granted: 05/18/1987 (almost 38 years ago)
- Expiry Date: 06/30/1995 (almost 30 years ago)
LOCATIONS
A Address
538 BROADWAY, ANDERSON IN 46018