Angela Phyllis LaSalle

Controlled Substance Registration - Physician

Indiana  01047101B   Active

This Indiana license is held by Angela Phyllis LaSalle. The license is currently active. It was granted on 08/25/1997 and expired on 10/31/2015

LICENSE DETAILS

  • License Number: 01047101B
  • Category: CSR-Physician
  • Status: Active
  • Date Granted: 08/25/1997 (about 29 years ago)
  • Expiry Date: 10/31/2015 (almost 11 years ago)

LOCATIONS

A Address

Ailanto Group, 3003 E 98th Street, Indianapolis IN 46280