Wallace Eugene Bash
Controlled Substance Registration - Physician
Indiana 01013971B Expired
This Indiana license was held by Wallace Eugene Bash. The license is no longer active. It was granted on 04/30/1986 and expired on 06/30/2001
LICENSE DETAILS
- License Number: 01013971B
- Category: CSR-Physician
- Status: Expired
- Date Granted: 04/30/1986 (about 39 years ago)
- Expiry Date: 06/30/2001 (almost 24 years ago)
LOCATIONS
A Address
6770 Covington Creek Trail, Fort Wayne IN 46804