Jess Bruce Wagner
Controlled Substance Registration - Physician
Indiana 01050647B Expired
This Indiana license was held by Jess Bruce Wagner. The license is no longer active. It was granted on 05/14/1999 and expired on 06/30/2005
LICENSE DETAILS
- License Number: 01050647B
- Category: CSR-Physician
- Status: Expired
- Date Granted: 05/14/1999 (about 26 years ago)
- Expiry Date: 06/30/2005 (almost 20 years ago)
LOCATIONS
A Address
661 Meadow Lark Lane, Bloomington IN 47408