License holder summary

Cameron Richard Gongwer is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Cameron Richard Gongwer is 4440 North Portage Ave., South Bend IN 46628. This licensed professional license is current. The license was granted 09/06/1990 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Cameron Richard Gongwer
Controlled Substance Registration - Physician
License number
01038547B
Date granted
09/06/1990
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
4440 North Portage Ave., South Bend IN 46628
indianalicensing.org
ID 5920547
LAST UPDATED 2024-02-01 12:23:51 UTC

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