Indiana
Professional Licensing Agency
Connie JoAnne Lubbehusen
Controlled Substance Registration-Physician Assistant
License number
10000811B
Date granted
04/23/2010
Date expires
06/30/2016
Class
Controlled Substance Registration-Physician Assistant
Status
Active
Address
PHYSICIANS URGENT CARE, 920 EAST COLISEUM BLVD., FORT WAYNE IN 46805
indianalicensing.org
ID 8386495
LAST UPDATED 2024-02-12 06:36:57 UTC
LAST UPDATED 2024-02-12 06:36:57 UTC
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