Amita Arun Manickam Bagal

Controlled Substance Registration - Physician

Indiana  01056913D   Expired

This Indiana license was held by Amita Arun Manickam Bagal. The license is no longer active. It was granted on 07/25/2007 and expired on 06/30/2009

LICENSE DETAILS

  • License Number: 01056913D
  • Category: CSR-Physician
  • Status: Expired
  • Date Granted: 07/25/2007 (about 19 years ago)
  • Expiry Date: 06/30/2009 (about 17 years ago)

LOCATIONS

A Address

Duneland Clinic, 810 Michael Drive, Suite I, Chesterton IN 46304