SEVERINO G GOMILLA
Controlled Substance Registration - Physician
Indiana 01022484B Revoked
This Indiana license was held by SEVERINO G GOMILLA. The license is no longer active. It was granted on 05/24/1994 and expired on 06/30/1995
LICENSE DETAILS
- License Number: 01022484B
- Category: CSR-Physician
- Status: Revoked
- Date Granted: 05/24/1994 (almost 31 years ago)
- Expiry Date: 06/30/1995 (almost 30 years ago)
LOCATIONS
A Address
727 MOON ROAD, PLAINFIELD IN 46168