MARK BALLARD
Controlled Substance Registration - Physician
Indiana 01029404B Expired
This Indiana license was held by MARK BALLARD. The license is no longer active. It was granted on 04/30/1986 and expired on 06/30/1995
LICENSE DETAILS
- License Number: 01029404B
- Category: CSR-Physician
- Status: Expired
- Date Granted: 04/30/1986 (almost 39 years ago)
- Expiry Date: 06/30/1995 (almost 30 years ago)
LOCATIONS
A Address
1300 STATE STREET, LAPORTE IN 46350