Indiana
Professional Licensing Agency
Philip Jay La Blonde
Controlled Substance Registration - Physician
License number
01027956B
Date granted
11/30/1986
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
15120 Honors Circle, Carmel IN 46033
indianalicensing.org
ID 5831643
LAST UPDATED 2024-04-15 05:30:10 UTC
LAST UPDATED 2024-04-15 05:30:10 UTC
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