Indiana
Professional Licensing Agency
JAY POLHEMUS
Controlled Substance Registration - Physician
License number
01025432B
Date granted
05/18/1987
Date expires
06/30/1995
Class
Controlled Substance Registration - Physician
Status
Suspended
Address
538 BROADWAY, ANDERSON IN 46018
indianalicensing.org
ID 5817399
LAST UPDATED 2024-02-18 06:30:46 UTC
LAST UPDATED 2024-02-18 06:30:46 UTC
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