Russell Wayne Stevens

Controlled Substance Registration - Physician

Indiana  01048851C   Expired

This Indiana license was held by Russell Wayne Stevens. The license is no longer active. It was granted on 11/24/2003 and expired on 06/30/2005

LICENSE DETAILS

  • License Number: 01048851C
  • Category: CSR-Physician
  • Status: Expired
  • Date Granted: 11/24/2003 (over 21 years ago)
  • Expiry Date: 06/30/2005 (almost 20 years ago)

LOCATIONS

A Address

Russell Wayne Stevens, 404 Slate Run Drive, Henryville IN 47126