Indiana
Professional Licensing Agency
Bertram S. Roth
Controlled Substance Registration - Physician
License number
01014825B
Date granted
08/31/1986
Date expires
06/30/2011
Class
Controlled Substance Registration - Physician
Status
Expired
Address
5227 KNOLLTON ROAD, INDIANAPOLIS IN 46228
indianalicensing.org
ID 5868932
LAST UPDATED 2024-05-13 04:38:39 UTC
LAST UPDATED 2024-05-13 04:38:39 UTC
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