License holder summary

Tyra Denee Gaylord is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Tyra Denee Gaylord is Neonatal Intensive Care Unit, 615 North Michigan Street, South Bend IN 46601. This licensed professional license is not current. The license was granted 06/30/1994 and expired on 06/30/2009.

Indiana

Professional Licensing Agency

Tyra Denee Gaylord
Controlled Substance Registration - Physician
License number
01042658B
Date granted
06/30/1994
Date expires
06/30/2009
Class
Controlled Substance Registration - Physician
Status
Expired
Address
Neonatal Intensive Care Unit, 615 North Michigan Street, South Bend IN 46601
indianalicensing.org
ID 5922461
LAST UPDATED 2024-02-23 10:20:03 UTC

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