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