Indiana
Professional Licensing Agency
Laurie J. Polubinsky
Controlled Substance Registration - Physician
License number
01059187B
Date granted
05/24/2004
Date expires
06/30/2011
Class
Controlled Substance Registration - Physician
Status
Expired
Address
1800 N. Oak Rd., Plymouth IN 46563
indianalicensing.org
ID 5910597
LAST UPDATED 2026-05-09 07:27:13 UTC
LAST UPDATED 2026-05-09 07:27:13 UTC
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