Indiana
Professional Licensing Agency
Queen Ann Marsh
Controlled Substance Registration - Physician
License number
01044794B
Date granted
09/27/1996
Date expires
06/30/1997
Class
Controlled Substance Registration - Physician
Status
Expired
Address
7127 INDIANAPOLIS BLVD, HAMMOND IN 46320
indianalicensing.org
ID 5865006
LAST UPDATED 2024-04-28 19:03:48 UTC
LAST UPDATED 2024-04-28 19:03:48 UTC
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