Indiana
Professional Licensing Agency
Krista E. Shackelford
Controlled Substance Registration - Physician
License number
01061838B
Date granted
05/16/2006
Date expires
06/30/2007
Class
Controlled Substance Registration - Physician
Status
Expired
Address
Dermatology Physicians, Inc., Tipton Park Plaza, 360 - C Plaza Dr., Columbus IN 47201
indianalicensing.org
ID 5836669
LAST UPDATED 2024-02-25 07:13:01 UTC
LAST UPDATED 2024-02-25 07:13:01 UTC
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