Indiana
Professional Licensing Agency
Lisa Michelle Clemens
Controlled Substance Registration-Physician Assistant
License number
10001224B
Date granted
03/23/2012
Date expires
06/30/2016
Class
Controlled Substance Registration-Physician Assistant
Status
Active
Address
PPG-CVS, 1818 Carew Street, Fort Wayne IN 46805
indianalicensing.org
ID 8386581
LAST UPDATED 2024-02-17 07:10:05 UTC
LAST UPDATED 2024-02-17 07:10:05 UTC
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