Indiana
Professional Licensing Agency
Polly Ellen Lybrook
Controlled Substance Registration - Physician
License number
01038468B
Date granted
07/19/1990
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
1501 E. Hillside, Suite 200, Bloomington IN 47401
indianalicensing.org
ID 5825511
LAST UPDATED 2024-03-08 21:07:12 UTC
LAST UPDATED 2024-03-08 21:07:12 UTC
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