Gautam Krishnaknat Shah

Controlled Substance Registration - Physician

Indiana  01029220B   Active

This Indiana license is held by Gautam Krishnaknat Shah. The license is currently active. It was granted on 06/30/1985 and expired on 10/31/2015

LICENSE DETAILS

  • License Number: 01029220B
  • Category: CSR-Physician
  • Status: Active
  • Date Granted: 06/30/1985 (almost 40 years ago)
  • Expiry Date: 10/31/2015 (over 9 years ago)

LOCATIONS

A Address

ST MARGERT MERCY HOSPITAL, 5454 HOHMAN AVENUE, HAMMOND IN 46320