Kim Waterfall
Controlled Substance Registration - Physician
Indiana 01025471B Expired
This Indiana license was held by Kim Waterfall. The license is no longer active. It was granted on 06/25/1996 and expired on 06/30/2009
LICENSE DETAILS
- License Number: 01025471B
- Category: CSR-Physician
- Status: Expired
- Date Granted: 06/25/1996 (almost 28 years ago)
- Expiry Date: 06/30/2009 (almost 15 years ago)
LOCATIONS
A Address
Ligonier Family Medicine, 1464 LINCOLNWAY SO P O BOX 293, LIGONIER IN 46767