Indiana
Professional Licensing Agency
Edward Lee Paul Shackleford
Controlled Substance Registration-Osteopathic Physician
License number
02001705B
Date granted
12/07/1995
Date expires
06/30/2001
Class
Controlled Substance Registration-Osteopathic Physician
Status
Expired
Address
St. Margaret Mercy North Emergency Dept., 5454 Hohman Avenue, Hammond IN 46320
indianalicensing.org
ID 5802405
LAST UPDATED 2024-04-06 07:10:48 UTC
LAST UPDATED 2024-04-06 07:10:48 UTC
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