Indiana
Professional Licensing Agency
Jack Huett Hall
Controlled Substance Registration - Physician
License number
01017725B
Date granted
03/31/1986
Date expires
10/31/2013
Class
Controlled Substance Registration - Physician
Status
Expired
Address
5960 Braewick Road, Indianapolis IN 46226
indianalicensing.org
ID 5869669
LAST UPDATED 2024-03-08 07:17:42 UTC
LAST UPDATED 2024-03-08 07:17:42 UTC
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