Indiana
Professional Licensing Agency
Pamela Ponder Fennewald
Controlled Substance Registration - Physician
License number
01030987B
Date granted
08/31/1986
Date expires
06/30/1989
Class
Controlled Substance Registration - Physician
Status
Expired
Address
720 E CEDAR #400, SOUTH BEND IN 46617
indianalicensing.org
ID 5921872
LAST UPDATED 2024-03-08 07:25:22 UTC
LAST UPDATED 2024-03-08 07:25:22 UTC
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