Indiana
Professional Licensing Agency
Myra Lynn Wise
Controlled Substance Registration - Physician
License number
01053240B
Date granted
11/30/2004
Date expires
06/30/2009
Class
Controlled Substance Registration - Physician
Status
Expired
Address
Good Samaritan Hospital, 520 South 7th Street, Vincennes IN 47591
indianalicensing.org
ID 5931258
LAST UPDATED 2024-04-13 05:39:06 UTC
LAST UPDATED 2024-04-13 05:39:06 UTC
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