License holder summary

Phyllis Martin-Simmerman is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Phyllis Martin-Simmerman is 2600 GREENBUSH STREET, LAFAYETTE IN 47904. This licensed professional license is not current. The license was granted 03/27/1985 and expired on 06/30/2011.

Indiana

Professional Licensing Agency

Phyllis Martin-Simmerman
Controlled Substance Registration - Physician
License number
01029841B
Date granted
03/27/1985
Date expires
06/30/2011
Class
Controlled Substance Registration - Physician
Status
Expired
Address
2600 GREENBUSH STREET, LAFAYETTE IN 47904
indianalicensing.org
ID 5880492
LAST UPDATED 2024-04-05 06:04:32 UTC

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