Indiana
Professional Licensing Agency
Lori Jacquemin Sanford
Controlled Substance Registration - Physician
License number
01072559B
Date granted
05/07/2013
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Greenfield Dermatology, 300 E. Boyd Ave. Ste 209, Greenfield IN 46140
indianalicensing.org
ID 5860536
LAST UPDATED 2024-05-19 08:27:10 UTC
LAST UPDATED 2024-05-19 08:27:10 UTC
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