Indiana
Professional Licensing Agency
Tara N. Riley
Controlled Substance Registration-Physician Assistant
License number
10001271B
Date granted
10/29/2012
Date expires
06/30/2016
Class
Controlled Substance Registration-Physician Assistant
Status
Active
Address
6330 E 75th Street - Suite 110, Indianapolis IN 46260-2717
indianalicensing.org
ID 8387481
LAST UPDATED 2024-05-09 03:10:29 UTC
LAST UPDATED 2024-05-09 03:10:29 UTC
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