Indiana
Professional Licensing Agency
Russell Eric Gilliom
Controlled Substance Registration - Dentist
License number
12007296B
Date granted
11/30/1984
Date expires
03/01/2014
Class
Controlled Substance Registration - Dentist
Status
Expired
Address
230 East Whitley St. P.O. Box 265, Churubusco IN 46723-0265
indianalicensing.org
ID 5086651
LAST UPDATED 2024-04-16 23:50:32 UTC
LAST UPDATED 2024-04-16 23:50:32 UTC
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