SAMUEL NIEN TSU WONG
Controlled Substance Registration - Physician
Indiana 01017838B Surrendered
This Indiana license was held by SAMUEL NIEN TSU WONG. The license is no longer active. It was granted on 06/30/1986 and expired on 06/30/1997
LICENSE DETAILS
- License Number: 01017838B
- Category: CSR-Physician
- Status: Surrendered
- Date Granted: 06/30/1986 (almost 39 years ago)
- Expiry Date: 06/30/1997 (almost 28 years ago)
LOCATIONS
A Address
6642 CALUMET AVENUE, HAMMOND IN 46324