Indiana
Professional Licensing Agency
Jeuti B. Wylde
Controlled Substance Registration - Physician
License number
01041261B
Date granted
10/27/1993
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
1114 E. 10th Street, Jeffersonville IN 47130
indianalicensing.org
ID 5873147
LAST UPDATED 2024-05-10 17:12:45 UTC
LAST UPDATED 2024-05-10 17:12:45 UTC
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