Michael Kooistra, Jr
Controlled Substance Registration - Physician
Indiana 01045333B Active
This Indiana license is held by Michael Kooistra, Jr. The license is currently active. It was granted on 07/01/1996 and expired on 10/31/2015
LICENSE DETAILS
- License Number: 01045333B
- Category: CSR-Physician
- Status: Active
- Date Granted: 07/01/1996 (about 30 years ago)
- Expiry Date: 10/31/2015 (almost 11 years ago)
LOCATIONS
A Address
6950 Daisy Street, Auburn IN 46706
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