Indiana
Professional Licensing Agency
Kellie Adrienne Park
Controlled Substance Registration - Physician
License number
01073835B
Date granted
04/09/2014
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
411 W. Tipton St., Seymour IN 47274
indianalicensing.org
ID 27719651
LAST UPDATED 2024-02-06 23:08:06 UTC
LAST UPDATED 2024-02-06 23:08:06 UTC
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