Indiana
Professional Licensing Agency
Suzanne Clair Watson Hansen
Controlled Substance Registration - Physician
License number
01059112B
Date granted
06/01/2004
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
14706 Geist Ridge Drive, Fortville IN 46040
indianalicensing.org
ID 5854910
LAST UPDATED 2024-04-28 11:06:19 UTC
LAST UPDATED 2024-04-28 11:06:19 UTC
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