Indiana
Professional Licensing Agency
A. Michelle Ferguson
Controlled Substance Registration-Physician Assistant
License number
10000621B
Date granted
12/07/2007
Date expires
06/30/2016
Class
Controlled Substance Registration-Physician Assistant
Status
Active
Address
Three Rivers Dermatology, 5650 Coventry Lane, Fort Wayne IN 46804
indianalicensing.org
ID 8386436
LAST UPDATED 2024-03-10 21:35:22 UTC
LAST UPDATED 2024-03-10 21:35:22 UTC
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