PETER B PARK

Controlled Substance Registration - Physician

Indiana  01054077B   Expired

This Indiana license was held by PETER B PARK. The license is no longer active. It was granted on 06/20/2001 and expired on 06/30/2007

LICENSE DETAILS

  • License Number: 01054077B
  • Category: CSR-Physician
  • Status: Expired
  • Date Granted: 06/20/2001 (almost 24 years ago)
  • Expiry Date: 06/30/2007 (almost 18 years ago)

LOCATIONS

A Address

Jamie Flynn, 1250 South Creasy Lane, Lafayette IN 47905