SUSAN MARIE KSIAZEK
Controlled Substance Registration - Physician
Indiana 01043421B Expired
This Indiana license was held by SUSAN MARIE KSIAZEK. The license is no longer active. It was granted on 02/01/1995 and expired on 06/30/2003
LICENSE DETAILS
- License Number: 01043421B
- Category: CSR-Physician
- Status: Expired
- Date Granted: 02/01/1995 (over 29 years ago)
- Expiry Date: 06/30/2003 (almost 21 years ago)
LOCATIONS
A Address
5541 WHITE HALL WAY, CARMEL IN 46033