Patrick William Stack

Controlled Substance Registration - Physician

Indiana  01033161B   Active

This Indiana license is held by Patrick William Stack. The license is currently active. It was granted on 03/31/1986 and expired on 10/31/2015

LICENSE DETAILS

  • License Number: 01033161B
  • Category: CSR-Physician
  • Status: Active
  • Date Granted: 03/31/1986 (about 39 years ago)
  • Expiry Date: 10/31/2015 (over 9 years ago)

LOCATIONS

A Address

KDH Madison Pediatrics, 1373 E. State Road 62, Madison IN 47250