Indiana
Professional Licensing Agency
Brittany A. Stout
Temporary Physician Assistant Permit
License number
99064789A
Date granted
11/13/2014
Date expires
08/13/2015
Class
Temporary Physician Assistant Permit
Status
Active
Address
Lawrenceburg IN 47025
indianalicensing.org
ID 29180992
LAST UPDATED 2024-02-20 13:54:37 UTC
LAST UPDATED 2024-02-20 13:54:37 UTC
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