Indiana
Professional Licensing Agency
Agnes Kenny
Controlled Substance Registration - Physician
License number
01031072B
Date granted
06/30/1986
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
1000 NORTH BROADWAY, PERU IN 46970
indianalicensing.org
ID 5909333
LAST UPDATED 2024-03-05 20:16:05 UTC
LAST UPDATED 2024-03-05 20:16:05 UTC
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