Indiana
Professional Licensing Agency
Jennifer A Dudak
Controlled Substance Registration-Physician Assistant
License number
10000671B
Date granted
03/28/2013
Date expires
06/30/2016
Class
Controlled Substance Registration-Physician Assistant
Status
Active
Address
Dermatology Associates of Northwest Indiana, 9120 Columbia Avenue, Munster IN 46321
indianalicensing.org
ID 8387881
LAST UPDATED 2024-03-11 23:38:28 UTC
LAST UPDATED 2024-03-11 23:38:28 UTC
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