License holder summary

CARLA JEAN BRUMBAUGH is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for CARLA JEAN BRUMBAUGH is Fort Wayne Radiology Association LLC, 3707 New Vision Dr. PO Bo 5602, Fort Wayne IN 46895-5602. This licensed professional license is current. The license was granted 05/11/1995 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

CARLA JEAN BRUMBAUGH
Controlled Substance Registration - Physician
License number
01041267B
Date granted
05/11/1995
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Fort Wayne Radiology Association LLC, 3707 New Vision Dr. PO Bo 5602, Fort Wayne IN 46895-5602
indianalicensing.org
ID 5853041
LAST UPDATED 2024-02-18 18:06:04 UTC

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