John Raphael Kim
Controlled Substance Registration - Physician
Indiana 01042685B Retired
This Indiana license was held by John Raphael Kim. The license is no longer active. It was granted on 06/30/1994 and expired on 10/31/2013
LICENSE DETAILS
- License Number: 01042685B
- Category: CSR-Physician
- Status: Retired
- Date Granted: 06/30/1994 (almost 31 years ago)
- Expiry Date: 10/31/2013 (over 11 years ago)
LOCATIONS
A Address
6119 West Jefferson Blvd, Fort Wayne IN 46804