License holder summary

Keith Robert Davis is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Keith Robert Davis is Women's Health Advantage, 7635 West Jefferson Blvd, Fort Wayne IN 46804. This licensed professional license is current. The license was granted 03/31/1994 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Keith Robert Davis
Controlled Substance Registration - Physician
License number
01042294B
Date granted
03/31/1994
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Women's Health Advantage, 7635 West Jefferson Blvd, Fort Wayne IN 46804
indianalicensing.org
ID 5853827
LAST UPDATED 2024-02-06 07:03:02 UTC

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