Indiana
Professional Licensing Agency
Tice Timothy Ashurst
Controlled Substance Registration-Osteopathic Physician
License number
02004412B
Date granted
05/07/2014
Date expires
10/31/2015
Class
Controlled Substance Registration-Osteopathic Physician
Status
Active
Address
10351 Dawsons Creek Blvd., Suite A-1, Fort Wayne IN 46825
indianalicensing.org
ID 27693918
LAST UPDATED 2024-04-19 02:44:20 UTC
LAST UPDATED 2024-04-19 02:44:20 UTC
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