Indiana
Professional Licensing Agency
Carolyn Anne Moore
Controlled Substance Registration-Physician Assistant
License number
10001163B
Date granted
07/29/2011
Date expires
06/30/2016
Class
Controlled Substance Registration-Physician Assistant
Status
Active
Address
136 East Cottom Avenue, New Albany IN 47150
indianalicensing.org
ID 8388102
LAST UPDATED 2024-02-20 18:14:29 UTC
LAST UPDATED 2024-02-20 18:14:29 UTC
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