Indiana
Professional Licensing Agency
Lorraine Diane Conklin
Controlled Substance Registration-Physician Assistant
License number
10000299B
Date granted
01/25/2008
Date expires
06/30/2016
Class
Controlled Substance Registration-Physician Assistant
Status
Active
Address
QHG of Fort Wayne, Inc, 7333 W Jefferson, Fort Wayne IN 46804
indianalicensing.org
ID 8386590
LAST UPDATED 2024-02-17 15:02:39 UTC
LAST UPDATED 2024-02-17 15:02:39 UTC
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