Indiana
Professional Licensing Agency
Kimberly Ann Goletz
Controlled Substance Registration-Physician Assistant
License number
10000544B
Date granted
03/31/2008
Date expires
06/30/2016
Class
Controlled Substance Registration-Physician Assistant
Status
Active
Address
Ortho Indy South, 1260 Innovation Parkway Suite# 100, Greenwood IN 46143
indianalicensing.org
ID 8386869
LAST UPDATED 2024-03-24 06:41:56 UTC
LAST UPDATED 2024-03-24 06:41:56 UTC
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