WAYNE ALBERT CROCKETT
Controlled Substance Registration - Physician
Indiana 01016729B Expired
This Indiana license was held by WAYNE ALBERT CROCKETT. The license is no longer active. It was granted on 11/30/1984 and expired on 06/30/2003
LICENSE DETAILS
- License Number: 01016729B
- Category: CSR-Physician
- Status: Expired
- Date Granted: 11/30/1984 (over 39 years ago)
- Expiry Date: 06/30/2003 (almost 21 years ago)
LOCATIONS
A Address
2723 South 7th Street, Suite E, Terre Haute IN 47802