Indiana
Professional Licensing Agency
Tara Suzanne Wakefield
Controlled Substance Registration - Physician
License number
01071536B
Date granted
08/03/2012
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Franciscan Immediate Care, 1001 N Madison Avenue, Greenwood IN 46142
indianalicensing.org
ID 5862653
LAST UPDATED 2024-04-22 02:56:44 UTC
LAST UPDATED 2024-04-22 02:56:44 UTC
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