Amita Arun Manickam Bagal
Controlled Substance Registration - Physician
Indiana 01056913B Expired
This Indiana license was held by Amita Arun Manickam Bagal. The license is no longer active. It was granted on 07/17/2003 and expired on 06/30/2007
LICENSE DETAILS
- License Number: 01056913B
- Category: CSR-Physician
- Status: Expired
- Date Granted: 07/17/2003 (about 23 years ago)
- Expiry Date: 06/30/2007 (about 19 years ago)
LOCATIONS
A Address
Uptown Facial Practice Surgery, LLC, 1101 East Glendale Blvd. Ste 113, Valparaiso IN 46383