Indiana
Professional Licensing Agency
June Hazel Pollydore
Controlled Substance Registration - Physician
License number
01056412B
Date granted
07/10/2002
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
275 West 12th Street, Peru IN 46970
indianalicensing.org
ID 5909514
LAST UPDATED 2026-06-06 10:43:05 UTC
LAST UPDATED 2026-06-06 10:43:05 UTC
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