Indiana
Professional Licensing Agency
Shane Timothy Sampson
Controlled Substance Registration - Physician
License number
01038529B
Date granted
07/01/1990
Date expires
06/30/1995
Class
Controlled Substance Registration - Physician
Status
Expired
Address
2300 WEST GILBERT ST, MUNCIE IN 47303
indianalicensing.org
ID 5899360
LAST UPDATED 2024-04-04 06:07:33 UTC
LAST UPDATED 2024-04-04 06:07:33 UTC
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