Indiana
Professional Licensing Agency
Jody L. Ellis
Controlled Substance Registration-Physician Assistant
License number
10000818B
Date granted
09/26/2008
Date expires
06/30/2016
Class
Controlled Substance Registration-Physician Assistant
Status
Active
Address
MUnster Radiology Group, 901 Macarthur Blvd., Munster IN 46321
indianalicensing.org
ID 8388057
LAST UPDATED 2024-04-12 07:19:49 UTC
LAST UPDATED 2024-04-12 07:19:49 UTC
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