MICHELLE BLAKE
Controlled Substance Registration - Physician
Indiana 01032365B Expired
This Indiana license was held by MICHELLE BLAKE. The license is no longer active. It was granted on 03/31/1985 and expired on 06/30/2003
LICENSE DETAILS
- License Number: 01032365B
- Category: CSR-Physician
- Status: Expired
- Date Granted: 03/31/1985 (about 41 years ago)
- Expiry Date: 06/30/2003 (almost 23 years ago)
LOCATIONS
A Address
6277 S Fox Chase, Pendleton IN 46064