JENNIE LEE PAYNE
Controlled Substance Registration - Physician
Indiana 01047314B Expired
This Indiana license was held by JENNIE LEE PAYNE. The license is no longer active. It was granted on 07/25/1997 and expired on 06/30/2005
LICENSE DETAILS
- License Number: 01047314B
- Category: CSR-Physician
- Status: Expired
- Date Granted: 07/25/1997 (almost 28 years ago)
- Expiry Date: 06/30/2005 (almost 20 years ago)
LOCATIONS
A Address
ST JOHNS HEALTH SYSTEM, ATTN: MEDICAL STAFF OFFICE, 2015 JACKSON STREET, ANDERSON IN 46016