Indiana
Professional Licensing Agency
Nicole Suzanne Boersma
Controlled Substance Registration - Physician
License number
01062609B
Date granted
08/14/2006
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Family Health Services, 509 Conrad Harcourt Way, Rushville IN 46173
indianalicensing.org
ID 5915921
LAST UPDATED 2024-04-01 01:22:36 UTC
LAST UPDATED 2024-04-01 01:22:36 UTC
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