Indiana
Professional Licensing Agency
Renata Charissa Moore
Controlled Substance Registration - Physician
License number
01050829B
Date granted
11/15/1999
Date expires
06/30/2001
Class
Controlled Substance Registration - Physician
Status
Expired
Address
5500 HOHMAN AVENUE STE 3A, HAMMOND IN 46320
indianalicensing.org
ID 5865076
LAST UPDATED 2024-03-06 16:53:39 UTC
LAST UPDATED 2024-03-06 16:53:39 UTC
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