Indiana
Professional Licensing Agency
Dolly Albert Boughaba
Controlled Substance Registration - Physician
License number
01072116B
Date granted
02/05/2013
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
1100 Reid Parkway, Richmond IN 47374
indianalicensing.org
ID 5912816
LAST UPDATED 2024-03-23 11:57:34 UTC
LAST UPDATED 2024-03-23 11:57:34 UTC
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