Sam Hansen

Controlled Substance Registration - Physician

Indiana  01054645B   Active

This Indiana license is held by Sam Hansen. The license is currently active. It was granted on 07/19/2001 and expired on 10/31/2015

LICENSE DETAILS

  • License Number: 01054645B
  • Category: CSR-Physician
  • Status: Active
  • Date Granted: 07/19/2001 (almost 24 years ago)
  • Expiry Date: 10/31/2015 (over 9 years ago)

LOCATIONS

A Address

St Vincent Medical Group, Inc, 3900 St. Francis Way, Suite 205, Lafayette IN 47905-4939