LIDIA STANA ILCUS

Controlled Substance Registration - Physician

Indiana  01044352B   Expired

This Indiana license was held by LIDIA STANA ILCUS. The license is no longer active. It was granted on 03/27/1997 and expired on 06/30/2001

LICENSE DETAILS

  • License Number: 01044352B
  • Category: CSR-Physician
  • Status: Expired
  • Date Granted: 03/27/1997 (over 29 years ago)
  • Expiry Date: 06/30/2001 (about 25 years ago)

LOCATIONS

A Address

712 BURGESS AVENUE LANE, RISING SUN IN 47040