License holder summary

Stacy Lynn Forst is a Controlled Substance Registration-Physician Assistant licensed to practice in Indiana. The address on file for Stacy Lynn Forst is Fort Wayne Medical Oncology and Hematology, INC., 11143 Parkview Plaza Drive Ste# 100, Fort Wayne IN 46845-1701. This licensed professional license is not current. The license was granted 05/27/2008 and expired on 06/30/2012.

Indiana

Professional Licensing Agency

Stacy Lynn Forst
Controlled Substance Registration-Physician Assistant
License number
10000517B
Date granted
05/27/2008
Date expires
06/30/2012
Class
Controlled Substance Registration-Physician Assistant
Status
Expired
Address
Fort Wayne Medical Oncology and Hematology, INC., 11143 Parkview Plaza Drive Ste# 100, Fort Wayne IN 46845-1701
indianalicensing.org
ID 8386652
LAST UPDATED 2024-05-17 16:56:37 UTC

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