Indiana
Professional Licensing Agency
Cristal Michele Boatright
Controlled Substance Registration-Physician Assistant
License number
10001494B
Date granted
03/01/2013
Date expires
06/30/2016
Class
Controlled Substance Registration-Physician Assistant
Status
Active
Address
Nuvera, 10202-A Coldwater Rd., Fort Wayne IN 46825
indianalicensing.org
ID 8386500
LAST UPDATED 2024-04-16 11:18:04 UTC
LAST UPDATED 2024-04-16 11:18:04 UTC
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