Indiana
Professional Licensing Agency
N. Judge King
Controlled Substance Registration - Physician
License number
01065562B
Date granted
07/09/2008
Date expires
06/30/2011
Class
Controlled Substance Registration - Physician
Status
Expired
Address
1500 Albany St. Suite# 906, Beech Grove IN 46107
indianalicensing.org
ID 5823036
LAST UPDATED 2024-02-24 18:25:19 UTC
LAST UPDATED 2024-02-24 18:25:19 UTC
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