Indiana
Professional Licensing Agency
Nitie Sroa
Controlled Substance Registration - Podiatrist
License number
07001153B
Date granted
03/06/2013
Date expires
06/30/2015
Class
Controlled Substance Registration - Podiatrist
Status
Active
Address
Northside Medical Center, 5250 East U.S. 36 #610, Avon IN 46123
indianalicensing.org
ID 8429654
LAST UPDATED 2026-05-19 10:17:20 UTC
LAST UPDATED 2026-05-19 10:17:20 UTC
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