Indiana
Professional Licensing Agency
Sridevi Sompalli
Controlled Substance Registration - Physician
License number
01069685B
Date granted
05/31/2011
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
620 W. Edison Rd., Ste 110, Mishawaka IN 46545
indianalicensing.org
ID 5895901
LAST UPDATED 2024-03-18 18:19:31 UTC
LAST UPDATED 2024-03-18 18:19:31 UTC
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