Indiana
Professional Licensing Agency
Jerry Padpad Co
Controlled Substance Registration - Physician
License number
01053020B
Date granted
10/26/2000
Date expires
06/30/2005
Class
Controlled Substance Registration - Physician
Status
Expired
Address
Grant Blackford Mental Health Inc., 505 Wabash Avenue, Marion IN 46952
indianalicensing.org
ID 5888187
LAST UPDATED 2026-03-28 02:46:30 UTC
LAST UPDATED 2026-03-28 02:46:30 UTC
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