Indiana
Professional Licensing Agency
Kristen Deann Jarvis
Controlled Substance Registration-Osteopathic Physician
License number
02003100B
Date granted
07/17/2006
Date expires
10/31/2013
Class
Controlled Substance Registration-Osteopathic Physician
Status
Expired
Address
Family Practice Center, 2434 Lake Avenue, Fort Wayne IN 46805
indianalicensing.org
ID 5800575
LAST UPDATED 2024-03-26 00:38:37 UTC
LAST UPDATED 2024-03-26 00:38:37 UTC
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