Indiana
Professional Licensing Agency
Princess Gloria Gaitawe-Johnson
Controlled Substance Registration - Physician
License number
01073248B
Date granted
10/09/2013
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Samaritan Center The Willows, 1901 Willow Street, Vincennes IN 47591
indianalicensing.org
ID 11963066
LAST UPDATED 2024-03-08 00:13:03 UTC
LAST UPDATED 2024-03-08 00:13:03 UTC
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