Indiana
Professional Licensing Agency
Gwendolyn Heaton
Controlled Substance Registration - Physician
License number
01035782B
Date granted
07/29/1987
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
606 East Main Street, Madison IN 47250
indianalicensing.org
ID 5886651
LAST UPDATED 2024-03-10 05:10:55 UTC
LAST UPDATED 2024-03-10 05:10:55 UTC
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