Indiana
Professional Licensing Agency
Gordon Bausman
Controlled Substance Registration - Dentist
License number
12007571B
Date granted
09/30/1986
Date expires
03/01/2014
Class
Controlled Substance Registration - Dentist
Status
Expired
Address
545 Park Avenue, Rensselaer IN 47978
indianalicensing.org
ID 5119542
LAST UPDATED 2024-03-02 11:23:46 UTC
LAST UPDATED 2024-03-02 11:23:46 UTC
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