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
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