Indiana
Professional Licensing Agency
Susan Siebenmorgen Amos
Controlled Substance Registration - Physician
License number
01031117B
Date granted
10/31/1985
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Providence Medical Group, 2723 South 7th Street, Suite C, Terre Haute IN 47802
indianalicensing.org
ID 5926735
LAST UPDATED 2026-04-18 13:03:52 UTC
LAST UPDATED 2026-04-18 13:03:52 UTC
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