Kenneth Wayne Anderson
Controlled Substance Registration - Physician
Indiana 01023328B Expired
This Indiana license was held by Kenneth Wayne Anderson. The license is no longer active. It was granted on 11/30/1978 and expired on 06/30/2007
LICENSE DETAILS
- License Number: 01023328B
- Category: CSR-Physician
- Status: Expired
- Date Granted: 11/30/1978 (over 47 years ago)
- Expiry Date: 06/30/2007 (about 19 years ago)
LOCATIONS
A Address
Johanna Kicherer, 560 Golden Place, Lafayette IN 47905