Indiana
Professional Licensing Agency
Jaime M. Sheperd
Controlled Substance Registration - Physician
License number
01042795B
Date granted
08/18/1997
Date expires
06/30/2007
Class
Controlled Substance Registration - Physician
Status
Expired
Address
Teri Roth, 14814 Van Pelt, Goshen IN 46526
indianalicensing.org
ID 5858667
LAST UPDATED 2024-03-03 13:05:28 UTC
LAST UPDATED 2024-03-03 13:05:28 UTC
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