Indiana
Professional Licensing Agency
Lisa Michele McTavish
Controlled Substance Registration - Physician
License number
01044255B
Date granted
08/31/1995
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
14 South Plank Street, Rossville IN 46065
indianalicensing.org
ID 5915708
LAST UPDATED 2024-02-08 15:24:58 UTC
LAST UPDATED 2024-02-08 15:24:58 UTC
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