Indiana
Professional Licensing Agency
Diamond Nicole Harris
Controlled Substance Registration - Physician
License number
01074348B
Date granted
07/23/2014
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
One Bethany Drive, 1373 East SR 62, Madison IN 47250
indianalicensing.org
ID 27712960
LAST UPDATED 2024-04-12 15:51:12 UTC
LAST UPDATED 2024-04-12 15:51:12 UTC
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