Indiana
Professional Licensing Agency
Shane James Rose
Controlled Substance Registration - Physician
License number
01049705G
Date granted
07/26/2010
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Medical Scanning and Consultants,P.A./Ctr for Diagnostic Img, 9819 East US Highway 36, Avon IN 46123-7954
indianalicensing.org
ID 5820645
LAST UPDATED 2026-05-11 12:24:09 UTC
LAST UPDATED 2026-05-11 12:24:09 UTC
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