Indiana
Professional Licensing Agency
Anita Rao
Controlled Substance Registration - Physician
License number
01070557B
Date granted
01/11/2012
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
3631 Willowcreek Rd., Portage IN 46368
indianalicensing.org
ID 5910928
LAST UPDATED 2024-04-04 15:57:03 UTC
LAST UPDATED 2024-04-04 15:57:03 UTC
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