Indiana
Professional Licensing Agency
Erin Kay Jefferson
Controlled Substance Registration-Osteopathic Physician
License number
02004168B
Date granted
03/15/2013
Date expires
10/31/2015
Class
Controlled Substance Registration-Osteopathic Physician
Status
Active
Address
Family Practice Center, 750 Broadway, Ste 350, Fort Wayne IN 46802
indianalicensing.org
ID 5800439
LAST UPDATED 2024-04-14 20:28:15 UTC
LAST UPDATED 2024-04-14 20:28:15 UTC
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