Indiana
Professional Licensing Agency
Pamela J. Kelly
Controlled Substance Registration - Physician
License number
01032407B
Date granted
04/30/1986
Date expires
06/30/2001
Class
Controlled Substance Registration - Physician
Status
Expired
Address
1912 CAREW STREET, FORT WAYNE IN 46805
indianalicensing.org
ID 5854149
LAST UPDATED 2024-02-18 02:19:36 UTC
LAST UPDATED 2024-02-18 02:19:36 UTC
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