Indiana
Professional Licensing Agency
BROOKE ASHLEY ANN JACKSON
Controlled Substance Registration - Physician
License number
01051872B
Date granted
12/22/1999
Date expires
06/30/2003
Class
Controlled Substance Registration - Physician
Status
Expired
Address
FAMILY CARE CENTERS OF INDIANA, 919 MAIN ST STE 201, DYER IN 46311
indianalicensing.org
ID 5844138
LAST UPDATED 2024-03-08 04:10:17 UTC
LAST UPDATED 2024-03-08 04:10:17 UTC
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