Stanley Jackson Self
Physician
Indiana 01055752A Expired Non-Renewable
This Indiana license was held by Stanley Jackson Self. The license is no longer active. It was granted on 02/20/2002 and expired on 06/30/2003
LICENSE DETAILS
- License Number: 01055752A
- Category: Physician
- Status: Expired Non-Renewable
- Date Granted: 02/20/2002 (over 22 years ago)
- Expiry Date: 06/30/2003 (almost 21 years ago)
LOCATIONS
A Address
Rome GA 30165