Indiana
Professional Licensing Agency
Susan Bantz
Controlled Substance Registration - Physician
License number
01049721B
Date granted
11/02/1998
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Family Health Services, 911 Central Avenue, Connersville IN 47331
indianalicensing.org
ID 5838374
LAST UPDATED 2024-04-06 15:45:23 UTC
LAST UPDATED 2024-04-06 15:45:23 UTC
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