Indiana
Professional Licensing Agency
JASON MICHAEL BURGETT
Controlled Substance Registration - Physician
License number
01046886B
Date granted
07/31/1997
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
1345 Unity Place Suite 245, Lafayette IN 47905
indianalicensing.org
ID 5879695
LAST UPDATED 2024-04-13 00:13:45 UTC
LAST UPDATED 2024-04-13 00:13:45 UTC
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