Person Information

Name:REGINA HAGGERTY PIDICH

Address Information

Address(city state zipcode):CLARKS SUMMIT PA18411

License Information

Type:Prescriptive AuthoritySecondary Type:Number:005960
Profession:NursingStatus:Agreement Terminated
Issue Date:1/11/2007Expires:10/31/2008Last Renewed:

Prerequisite Information

Licensee:PATEL, BHUPENDRA RRelationship:Collaborating Physician
Type:Medical Physician and SurgeonNumber:MD033103EStatus:Active
Date of Association:1/11/2007Date of Expiration:12/1/2008

Licensee:PIDICH, REGINA HAGGERTYRelationship:Prescriptive Authority
Type:Certified Registered Nurse PractitionerNumber:TP002122BStatus:Active
Date of Association:Date of Expiration:

License CSR Information

Drug Schedule 2:YDrug Schedule 3:YDrug Schedule 4:YDrug Schedule 5:

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