Indiana
Professional Licensing Agency
Lori Lynn Fuqua
Controlled Substance Registration - Physician
License number
01036109B
Date granted
07/01/1987
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
4781 Kaybee Drive, Gas City IN 46933
indianalicensing.org
ID 5858024
LAST UPDATED 2024-03-23 08:51:18 UTC
LAST UPDATED 2024-03-23 08:51:18 UTC
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