Indiana
Professional Licensing Agency
Fatima Kazem
Controlled Substance Registration - Physician
License number
01053505C
Date granted
06/14/2007
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
3032 Hamilton Street, West Lafayette IN 47906
indianalicensing.org
ID 5934009
LAST UPDATED 2024-02-09 22:06:05 UTC
LAST UPDATED 2024-02-09 22:06:05 UTC
This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.