Indiana
Professional Licensing Agency
Avida N. Bussell
Controlled Substance Registration - Physician
License number
01071399B
Date granted
07/03/2012
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
IU Health LaPorte Hospital, 1007 Lincolnway, La Porte IN 46350
indianalicensing.org
ID 5877643
LAST UPDATED 2024-04-06 10:02:22 UTC
LAST UPDATED 2024-04-06 10:02:22 UTC
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