Reynolds B Brissenden
Controlled Substance Registration - Physician
Indiana 01022544C Expired
This Indiana license was held by Reynolds B Brissenden. The license is no longer active. It was granted on 11/30/2007 and expired on 06/30/2009
LICENSE DETAILS
- License Number: 01022544C
- Category: CSR-Physician
- Status: Expired
- Date Granted: 11/30/2007 (over 18 years ago)
- Expiry Date: 06/30/2009 (almost 17 years ago)
LOCATIONS
A Address
NIOMS, 3220 Lancer Street, Portage IN 46368