Indiana
Professional Licensing Agency
Kristen S. Ingram
Controlled Substance Registration - Physician
License number
01060058B
Date granted
07/08/2005
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
7820 South Voyles Road, Pekin IN 47165
indianalicensing.org
ID 5909122
LAST UPDATED 2024-04-05 09:23:55 UTC
LAST UPDATED 2024-04-05 09:23:55 UTC
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