Indiana
Professional Licensing Agency
Lisa Kay Montgomery
Controlled Substance Registration-Physician Assistant
License number
10000327B
Date granted
10/26/2007
Date expires
06/30/2016
Class
Controlled Substance Registration-Physician Assistant
Status
Active
Address
3309 S 750 W, Russiaville IN 46979
indianalicensing.org
ID 8388402
LAST UPDATED 2026-05-25 15:37:15 UTC
LAST UPDATED 2026-05-25 15:37:15 UTC
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