Gautham Viswanathan
Controlled Substance Registration - Physician
Indiana 01059360B Active
This Indiana license is held by Gautham Viswanathan. The license is currently active. It was granted on 07/07/2004 and expired on 10/31/2015
LICENSE DETAILS
- License Number: 01059360B
- Category: CSR-Physician
- Status: Active
- Date Granted: 07/07/2004 (almost 21 years ago)
- Expiry Date: 10/31/2015 (over 9 years ago)
LOCATIONS
A Address
6924 Indianapolis Blvd., Hammond IN 46324
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