Indiana
Professional Licensing Agency
Heather Marie Stultz
Controlled Substance Registration-Physician Assistant
License number
10000754B
Date granted
01/25/2008
Date expires
06/30/2016
Class
Controlled Substance Registration-Physician Assistant
Status
Active
Address
1801 Clifty Drive, Madison IN 47250
indianalicensing.org
ID 8387811
LAST UPDATED 2024-02-18 09:01:14 UTC
LAST UPDATED 2024-02-18 09:01:14 UTC
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