Indiana
Professional Licensing Agency
Samuel Shorter
Controlled Substance Registration-Physician Assistant
License number
10000238B
Date granted
01/25/2008
Date expires
06/30/2016
Class
Controlled Substance Registration-Physician Assistant
Status
Active
Address
QHG of Fort Wayne, Inc, 11635 Coldwater Road, Fort Wayne IN 46845
indianalicensing.org
ID 8386647
LAST UPDATED 2024-05-13 13:51:40 UTC
LAST UPDATED 2024-05-13 13:51:40 UTC
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