Sung Jae Park
Controlled Substance Registration - Physician
Indiana 01051341B Active
This Indiana license is held by Sung Jae Park. The license is currently active. It was granted on 11/18/1999 and expired on 10/31/2015
LICENSE DETAILS
- License Number: 01051341B
- Category: CSR-Physician
- Status: Active
- Date Granted: 11/18/1999 (over 26 years ago)
- Expiry Date: 10/31/2015 (over 10 years ago)
LOCATIONS
A Address
Kosciusko Family Healthcare, 2235 Dubois Dr., Warsaw IN 46580
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