Indiana
Professional Licensing Agency
Angela Miller Bennett
Controlled Substance Registration - Physician
License number
01057217B
Date granted
02/12/2003
Date expires
06/30/2007
Class
Controlled Substance Registration - Physician
Status
Expired
Address
Portage Health Center, 6375 US Hwy 6, Portage IN 46368
indianalicensing.org
ID 5910910
LAST UPDATED 2024-04-10 00:28:25 UTC
LAST UPDATED 2024-04-10 00:28:25 UTC
This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.