SAMPANTA BOONJARERN
Controlled Substance Registration - Physician
Indiana 01027321B Expired
This Indiana license was held by SAMPANTA BOONJARERN. The license is no longer active. It was granted on 11/30/1986 and expired on 10/31/2013
LICENSE DETAILS
- License Number: 01027321B
- Category: CSR-Physician
- Status: Expired
- Date Granted: 11/30/1986 (over 38 years ago)
- Expiry Date: 10/31/2013 (over 11 years ago)
LOCATIONS
A Address
Sampanta Boonjarern, 297 FRANCISCAN ROAD #207, CROWN POINT IN 46307