Ima A Test Zzz03
Controlled Substance Registration-Physician Assistant
Indiana 10000000B Expired
This Indiana license was held by Ima A Test Zzz03. The license is no longer active. It was granted on 06/27/2007 and expired on 06/30/2014
LICENSE DETAILS
- License Number: 10000000B
- Category: CSR-Physician Assistant
- Status: Expired
- Date Granted: 06/27/2007 (almost 17 years ago)
- Expiry Date: 06/30/2014 (almost 10 years ago)
LOCATIONS
A Address
CSR B Phys Asst, 402 W. Washington St. Room W072, Indianapolis IN 46204