Indiana
Professional Licensing Agency
Anne Marie Fogle
Controlled Substance Registration - Physician
License number
01064188B
Date granted
11/30/2007
Date expires
10/31/2013
Class
Controlled Substance Registration - Physician
Status
Expired
Address
368 W. Old 62, Leavenworth IN 47137
indianalicensing.org
ID 5883651
LAST UPDATED 2024-04-26 09:29:23 UTC
LAST UPDATED 2024-04-26 09:29:23 UTC
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