Amita Arun Manickam Bagal
Controlled Substance Registration - Physician
Indiana 01056913C Expired
This Indiana license was held by Amita Arun Manickam Bagal. The license is no longer active. It was granted on 06/03/2004 and expired on 06/30/2011
LICENSE DETAILS
- License Number: 01056913C
- Category: CSR-Physician
- Status: Expired
- Date Granted: 06/03/2004 (almost 21 years ago)
- Expiry Date: 06/30/2011 (almost 14 years ago)
LOCATIONS
A Address
3190 Lancer Street, Portage IN 46368