Indiana
Professional Licensing Agency
Laura Elizabeth Blackford
Controlled Substance Registration - Physician
License number
01074430B
Date granted
08/12/2014
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Plymouth Family & Internal Medicine, 2349 Lake Avenue, Suite 100, Plymouth IN 46563
indianalicensing.org
ID 27718037
LAST UPDATED 2024-03-08 09:24:26 UTC
LAST UPDATED 2024-03-08 09:24:26 UTC
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