Indiana
Professional Licensing Agency
Susan Renay Pittman
Controlled Substance Registration - Physician
License number
01050923B
Date granted
07/28/1999
Date expires
06/30/2001
Class
Controlled Substance Registration - Physician
Status
Expired
Address
BALL FAMILY PRACTICE CENTER, 2300 W GILBERT ST, MUNCIE IN 47302
indianalicensing.org
ID 5899465
LAST UPDATED 2024-04-28 11:27:44 UTC
LAST UPDATED 2024-04-28 11:27:44 UTC
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