Cameron Richard Gongwer

Controlled Substance Registration - Physician

Indiana  01038547B   Active

This Indiana license is held by Cameron Richard Gongwer. The license is currently active. It was granted on 09/06/1990 and expired on 10/31/2015

LICENSE DETAILS

  • License Number: 01038547B
  • Category: CSR-Physician
  • Status: Active
  • Date Granted: 09/06/1990 (almost 36 years ago)
  • Expiry Date: 10/31/2015 (over 10 years ago)

LOCATIONS

A Address

4440 North Portage Ave., South Bend IN 46628