Indiana
Professional Licensing Agency
James A. Wallace
Controlled Substance Registration - Physician
License number
01065055B
Date granted
04/02/2008
Date expires
10/31/2013
Class
Controlled Substance Registration - Physician
Status
Expired
Address
1600 S Lake Park Ste 1101, Hobart IN 46342
indianalicensing.org
ID 5867191
LAST UPDATED 2024-03-18 16:24:50 UTC
LAST UPDATED 2024-03-18 16:24:50 UTC
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