TAE HONG PARK
Controlled Substance Registration - Physician
Indiana 01030973B Revoked
This Indiana license was held by TAE HONG PARK. The license is no longer active. It was granted on 12/31/1985 and expired on 06/30/1995
LICENSE DETAILS
- License Number: 01030973B
- Category: CSR-Physician
- Status: Revoked
- Date Granted: 12/31/1985 (over 39 years ago)
- Expiry Date: 06/30/1995 (almost 30 years ago)
LOCATIONS
A Address
P O BOX 1927, 8731 INDIANAPOLIS BOULEVARD, HIGHLAND IN 46322