Indiana
Professional Licensing Agency
Lauren Gevana Outlaw
Controlled Substance Registration - Physician
License number
01064686B
Date granted
06/28/2010
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
For Women Only, 1215 Lawn Ave. Suite# 100, Elkhart IN 46514
indianalicensing.org
ID 5847801
LAST UPDATED 2024-04-21 07:27:42 UTC
LAST UPDATED 2024-04-21 07:27:42 UTC
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