Indiana
Professional Licensing Agency
Ana Maria Jimenez
Controlled Substance Registration-Physician Assistant
License number
10000833B
Date granted
03/03/2009
Date expires
06/30/2010
Class
Controlled Substance Registration-Physician Assistant
Status
Expired
Address
Pediatrics Center of Fort Wayne, 2930 Lake Avenue, Fort Wayne IN 46805
indianalicensing.org
ID 8386447
LAST UPDATED 2024-03-09 05:01:37 UTC
LAST UPDATED 2024-03-09 05:01:37 UTC
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