Indiana
Professional Licensing Agency
Jesse E. Phillips
Controlled Substance Registration - Physician
License number
01040385B
Date granted
06/25/1992
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
1791 WEST THIRD STREET, BLOOMINGTON IN 47403
indianalicensing.org
ID 5824784
LAST UPDATED 2024-01-15 02:09:38 UTC
LAST UPDATED 2024-01-15 02:09:38 UTC
This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.