License holder summary

Lisa Tamara Harley is a Controlled Substance Registration-Physician Assistant licensed to practice in Indiana. The address on file for Lisa Tamara Harley is Parkview First Care, 3909 New Vision Drive, Fort Wayne IN 46845-1725. This licensed professional license is not current. The license was granted 09/27/2011 and expired on 06/30/2014.

Indiana

Professional Licensing Agency

Lisa Tamara Harley
Controlled Substance Registration-Physician Assistant
License number
10001309B
Date granted
09/27/2011
Date expires
06/30/2014
Class
Controlled Substance Registration-Physician Assistant
Status
Expired
Address
Parkview First Care, 3909 New Vision Drive, Fort Wayne IN 46845-1725
indianalicensing.org
ID 8386582
LAST UPDATED 2024-02-22 11:20:55 UTC

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