Indiana
Professional Licensing Agency
Kaly Liell
Controlled Substance Registration - Physician
License number
01026883B
Date granted
07/31/1986
Date expires
06/30/2009
Class
Controlled Substance Registration - Physician
Status
Expired
Address
60284 U S 31 South, South Bend IN 46614
indianalicensing.org
ID 5921454
LAST UPDATED 2026-05-10 13:28:44 UTC
LAST UPDATED 2026-05-10 13:28:44 UTC
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