Mouhammad Bassel Ericsoussi

Controlled Substance Registration - Physician

Indiana  01069620B   Active

This Indiana license is held by Mouhammad Bassel Ericsoussi. The license is currently active. It was granted on 11/04/2011 and expired on 10/31/2015

LICENSE DETAILS

  • License Number: 01069620B
  • Category: CSR-Physician
  • Status: Active
  • Date Granted: 11/04/2011 (over 13 years ago)
  • Expiry Date: 10/31/2015 (over 9 years ago)

LOCATIONS

A Address

Franciscan Medical Specialists, 5529 Hohman Avenue, Hammond IN 46320