Indiana
Professional Licensing Agency
Amy Vanessa Villavicencio
Controlled Substance Registration - Physician
License number
01060760B
Date granted
05/25/2005
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
550 S. Hoke Avenue, Frankfort IN 46041-2664
indianalicensing.org
ID 5854977
LAST UPDATED 2024-05-09 21:25:49 UTC
LAST UPDATED 2024-05-09 21:25:49 UTC
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