Amy Hagstrom Miller knew it wouldn’t be easy to run an abortion clinic in Indiana.

But she didn’t expect to get a letter from the Indiana State Department of Health (ISDH) denying her application to open a clinic in South Bend on the grounds that her organization is not “of reputable and responsible character.”

“That sentence is incredibly offensive,” Hagstrom Miller, president and CEO of Whole Woman’s Health Alliance, said in an interview with Rewire. “Every single thing they have asked of us we have complied with and responded to promptly and accurately.”

Five months after her organization first applied for the license, Indiana officials said the applicants had filed “inaccurate statements or information” and “failed to meet the requirement that the applicant is of reputable and responsible character.”

Hagstrom Miller said the organization would file an appeal, which the letter said they must do by January 23. She said Whole Woman’s Health Alliance—a nonprofit she founded to address anti-abortion stigma and provide care in states with onerous regulations on the medical procedure—had obtained licenses to perform abortions in Charlottesville, Virginia, and Austin, Texas, without issue.

In its letter, the Indiana State Department of Health said the organization “failed to disclose, concealed, or omitted information related to additional clinics,” suggesting they may have conflated Whole Woman’s Health Alliance with Whole Woman’s Health, Hagstrom Miller’s for-profit organization which won the 2016 U.S. Supreme Court case upholding abortion access in Texas. An ISDH spokesperson said they were unable to comment “because the appeals window is open.”

Indiana has six abortion clinics: three in Indianapolis, and the rest in Bloomington, Lafayette, and Merrillville. A number of clinics closed on the watch of anti-choice extremist Vice President Mike Pence, who signed at least eight anti-choice laws as Indiana governor.

Because Indiana requires abortion clinics to meet the building standards of ambulatory surgery centers, Hagstrom Miller’s organization applied for a waiver to perform only medication abortions. (Hagstrom Miller defeated these medically unnecessary building requirements at the Supreme Court in the Texas case, but such rules remain in place in states nationwide.)

Hagstrom Miller said Indiana’s regulatory hurdles, along with support from residents who urged her to open a clinic there, helped draw her to the state. “I see that as a place for Whole Woman’s Health Alliance to come in and say: Women in these communities deserve high-quality care, they deserve the same access that people next door in Illinois get to have,” Hagstrom Miller told Rewire.

Anti-choice groups in Indiana had mobilized to block the opening of the South Bend clinic. In an interview with Rewire, Antonio Marchi, program director at St. Joseph County Right to Life, praised the decision to deny the license, saying the health department had “recognized some very serious concerns with Whole Woman’s Health’s track record in terms of health and safety violations.”

Pressed by Rewire on what evidence he had for this claim, since the department’s letter makes no mention of health or safety violations, Marchi acknowledged it was only his speculation. The South Bend Tribune, however, published his claims about the basis for the department’s decision without substantiating them.

“Let me clarify that I am actually unaware of a state communication expressing concerns over violations at other clinics,” Marchi wrote in a follow-up email.