Shane David Bush

Controlled Substance Registration - Physician

Indiana  01071914B   Active

This Indiana license is held by Shane David Bush. The license is currently active. It was granted on 04/08/2013 and expired on 10/31/2015

LICENSE DETAILS

  • License Number: 01071914B
  • Category: CSR-Physician
  • Status: Active
  • Date Granted: 04/08/2013 (about 13 years ago)
  • Expiry Date: 10/31/2015 (over 10 years ago)

LOCATIONS

A Address

Porter Medical Group, 3630 Willowcreek Rd., Portage IN 46368