Indiana
Professional Licensing Agency
Heather Marie Stark
Controlled Substance Registration-Physician Assistant
License number
10000827B
Date granted
01/25/2008
Date expires
06/30/2008
Class
Controlled Substance Registration-Physician Assistant
Status
Expired
Address
QHG of Fort Wayne, Inc, 3717 Maplecrest, Fort Wayne IN 46815
indianalicensing.org
ID 8386521
LAST UPDATED 2024-02-25 16:52:34 UTC
LAST UPDATED 2024-02-25 16:52:34 UTC
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