Indiana
Professional Licensing Agency
Lilly S Bontrager
Controlled Substance Registration - Physician
License number
01061077B
Date granted
07/29/2005
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Brooklyn Medical Associates, 326 Sawyer Road, Kendallville IN 46755
indianalicensing.org
ID 5874974
LAST UPDATED 2024-04-13 00:43:33 UTC
LAST UPDATED 2024-04-13 00:43:33 UTC
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