Indiana
Professional Licensing Agency
Terry L. Frederick
Controlled Substance Registration - Physician
License number
01024046C
Date granted
08/07/2002
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
326 EMS W17 Lane, North Webster IN 46555
indianalicensing.org
ID 5907918
LAST UPDATED 2024-03-28 03:01:51 UTC
LAST UPDATED 2024-03-28 03:01:51 UTC
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