Mark Jay Mc Gillem
Controlled Substance Registration - Physician
Indiana 01051194B Expired
This Indiana license was held by Mark Jay Mc Gillem. The license is no longer active. It was granted on 08/09/1999 and expired on 10/31/2013
LICENSE DETAILS
- License Number: 01051194B
- Category: CSR-Physician
- Status: Expired
- Date Granted: 08/09/1999 (almost 26 years ago)
- Expiry Date: 10/31/2013 (over 11 years ago)
LOCATIONS
A Address
615 N Michigan Street, Suite 703, South Bend IN 46601