Jerry Richard Hickman
Controlled Substance Registration - Dentist
Indiana 12006199B Expired
This Indiana license was held by Jerry Richard Hickman. The license is no longer active. It was granted on 06/22/1965 and expired on 03/01/2008
LICENSE DETAILS
- License Number: 12006199B
- Category: CSR-Dentist
- Status: Expired
- Date Granted: 06/22/1965 (about 61 years ago)
- Expiry Date: 03/01/2008 (over 18 years ago)
LOCATIONS
A Address
8001 SHELBY STREET, INDIANAPOLIS IN 46227