Lito Bautista Fajardo
Controlled Substance Registration - Physician
Indiana 01027493B Active
This Indiana license is held by Lito Bautista Fajardo. The license is currently active. It was granted on 06/05/2014 and expired on 10/31/2015
LICENSE DETAILS
- License Number: 01027493B
- Category: CSR-Physician
- Status: Active
- Date Granted: 06/05/2014 (almost 11 years ago)
- Expiry Date: 10/31/2015 (over 9 years ago)
LOCATIONS
A Address
South Bend Specialty Surgery Center, 335 Florence Ave, suite 1-B, Granger IN 46530
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