Indiana
Professional Licensing Agency
Nicole Camille Antao
Controlled Substance Registration-Physician Assistant
License number
10001023B
Date granted
01/29/2010
Date expires
06/30/2016
Class
Controlled Substance Registration-Physician Assistant
Status
Active
Address
Community Pulmonary & Critical Care Medicine, 7120 Clearvista Drive, Indianapolis IN 46251
indianalicensing.org
ID 8387406
LAST UPDATED 2024-03-03 14:51:20 UTC
LAST UPDATED 2024-03-03 14:51:20 UTC
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