Indiana
Professional Licensing Agency
Rebecca R. Small
Controlled Substance Registration - Physician
License number
01063143C
Date granted
05/24/2010
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Avon Family Medicine, 6845 US 36, Avon IN 46123-8132
indianalicensing.org
ID 5820535
LAST UPDATED 2024-06-01 04:21:26 UTC
LAST UPDATED 2024-06-01 04:21:26 UTC
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