John Shively
Controlled Substance Registration - Physician
Indiana 01032390C Expired
This Indiana license was held by John Shively. The license is no longer active. It was granted on 01/31/1986 and expired on 06/30/1991
LICENSE DETAILS
- License Number: 01032390C
- Category: CSR-Physician
- Status: Expired
- Date Granted: 01/31/1986 (over 40 years ago)
- Expiry Date: 06/30/1991 (about 35 years ago)
LOCATIONS
A Address
4001 Wabash Avenue, West Lafayette IN 47906