Indiana
Professional Licensing Agency
Mary Ellen Black
Controlled Substance Registration - Physician
License number
01042492B
Date granted
05/26/1994
Date expires
06/30/1995
Class
Controlled Substance Registration - Physician
Status
Expired
Address
2400 EAST 17 TH STREET, COLUMBUS IN 47201
indianalicensing.org
ID 5836766
LAST UPDATED 2024-02-22 18:07:03 UTC
LAST UPDATED 2024-02-22 18:07:03 UTC
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