Indiana
Professional Licensing Agency
Keith W. Ivens
Controlled Substance Registration - Physician
License number
01044224C
Date granted
08/31/1995
Date expires
06/30/1999
Class
Controlled Substance Registration - Physician
Status
Expired
Address
727 MOON ROAD, PLAINFIELD IN 46168
indianalicensing.org
ID 5910152
LAST UPDATED 2024-04-26 04:04:48 UTC
LAST UPDATED 2024-04-26 04:04:48 UTC
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