Indiana
Professional Licensing Agency
Sherriff Alli Balogun
Controlled Substance Registration - Physician
License number
01051719C
Date granted
08/13/2001
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Parkview Lagrange Hospital, 207 N. Town Line Rd., Lagrange IN 46761
indianalicensing.org
ID 5881149
LAST UPDATED 2024-05-06 09:09:42 UTC
LAST UPDATED 2024-05-06 09:09:42 UTC
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