License holder summary

Bo Tyler Headlam is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Bo Tyler Headlam is 11456 S. Broadway, Crown Point IN 46307. This licensed professional license is current. The license was granted 06/24/2011 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Bo Tyler Headlam
Controlled Substance Registration - Physician
License number
01069836B
Date granted
06/24/2011
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
11456 S. Broadway, Crown Point IN 46307
indianalicensing.org
ID 5840784
LAST UPDATED 2024-02-06 02:30:54 UTC

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