Jerry Edward Douglas
Controlled Substance Registration - Physician
Indiana 01032101B Expired
This Indiana license was held by Jerry Edward Douglas. The license is no longer active. It was granted on 12/31/1985 and expired on 06/30/2009
LICENSE DETAILS
- License Number: 01032101B
- Category: CSR-Physician
- Status: Expired
- Date Granted: 12/31/1985 (over 40 years ago)
- Expiry Date: 06/30/2009 (about 17 years ago)
LOCATIONS
A Address
2800 FERRY STREET, LAFAYETTE IN 47904