Indiana
Professional Licensing Agency
Jeryl G. Fullen
Controlled Substance Registration - Physician
License number
01063517B
Date granted
09/02/2010
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Fayette Regional Health System, 1941 Virginia Ave., Connersville IN 47331
indianalicensing.org
ID 5837922
LAST UPDATED 2024-04-16 11:59:40 UTC
LAST UPDATED 2024-04-16 11:59:40 UTC
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