Indiana
Professional Licensing Agency
Patricia A. Moore
Controlled Substance Registration - Podiatrist
License number
07000521B
Date granted
03/31/1986
Date expires
06/30/2015
Class
Controlled Substance Registration - Podiatrist
Status
Active
Address
52303 Emmons Road # 30, South Bend IN 46637
indianalicensing.org
ID 8443175
LAST UPDATED 2024-04-21 12:04:30 UTC
LAST UPDATED 2024-04-21 12:04:30 UTC
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