Indiana
Professional Licensing Agency
Lisa Ann Lane
Controlled Substance Registration - Physician
License number
01046721B
Date granted
05/22/1997
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Parkview FirstCare, 104 Nicholas Place, Avilla IN 46710
indianalicensing.org
ID 5819859
LAST UPDATED 2024-03-05 15:07:45 UTC
LAST UPDATED 2024-03-05 15:07:45 UTC
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