Russell Wayne Stevens
Controlled Substance Registration - Physician
Indiana 01048851B Surrendered
This Indiana license was held by Russell Wayne Stevens. The license is no longer active. It was granted on 06/25/1998 and expired on 06/30/2001
LICENSE DETAILS
- License Number: 01048851B
- Category: CSR-Physician
- Status: Surrendered
- Date Granted: 06/25/1998 (almost 28 years ago)
- Expiry Date: 06/30/2001 (almost 25 years ago)
LOCATIONS
A Address
7704 DEER RUN DR, HENRYVILLE IN 47126