Indiana
Professional Licensing Agency
Jennifer Leigh Bonafede
Controlled Substance Registration-Physician Assistant
License number
10001068B
Date granted
02/27/2009
Date expires
06/30/2010
Class
Controlled Substance Registration-Physician Assistant
Status
Expired
Address
Provience Retirement Home, 4915 Charlestown Rd., New Albany IN 47150
indianalicensing.org
ID 8388112
LAST UPDATED 2026-04-27 01:50:39 UTC
LAST UPDATED 2026-04-27 01:50:39 UTC
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