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
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