Tatyana Rashelle Demidovich

Controlled Substance Registration - Physician

Indiana  01059495B   Expired

This Indiana license was held by Tatyana Rashelle Demidovich. The license is no longer active. It was granted on 07/09/2004 and expired on 06/30/2009

LICENSE DETAILS

  • License Number: 01059495B
  • Category: CSR-Physician
  • Status: Expired
  • Date Granted: 07/09/2004 (almost 21 years ago)
  • Expiry Date: 06/30/2009 (almost 16 years ago)

LOCATIONS

A Address

St. Margaret Mercy Hospital/Medical Staff Office, 5454 Hohman Ave., Hammond IN 46320