License holder summary

Mary Lee Bouldin is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Mary Lee Bouldin is LifeSpring, Inc, 460 Spring Street, JEFFERSONVILLE IN 47130. This licensed professional license is current. The license was granted 10/29/1992 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Mary Lee Bouldin
Controlled Substance Registration - Physician
License number
01040813B
Date granted
10/29/1992
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
LifeSpring, Inc, 460 Spring Street, JEFFERSONVILLE IN 47130
indianalicensing.org
ID 5873655
LAST UPDATED 2024-03-24 07:13:20 UTC

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