Indiana
Professional Licensing Agency
Lauren D. Fahey
Controlled Substance Registration-Physician Assistant
License number
10001131B
Date granted
05/31/2011
Date expires
06/30/2016
Class
Controlled Substance Registration-Physician Assistant
Status
Active
Address
Dermatology Inc., 1115 N. Ronald Reagan Pkwy. #348, Avon IN 46123
indianalicensing.org
ID 8385742
LAST UPDATED 2024-04-02 03:53:55 UTC
LAST UPDATED 2024-04-02 03:53:55 UTC
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