Indiana
Professional Licensing Agency
Erinn C. Fuller
Controlled Substance Registration-Physician Assistant
License number
10001520B
Date granted
06/03/2013
Date expires
06/30/2016
Class
Controlled Substance Registration-Physician Assistant
Status
Active
Address
Northern Indiana Center for Pelvic Health and Gynecology, 707 North Michigan Street Suite 102, South Bend IN 46601
indianalicensing.org
ID 8388526
LAST UPDATED 2024-03-17 05:40:53 UTC
LAST UPDATED 2024-03-17 05:40:53 UTC
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