Indiana
Professional Licensing Agency
Fardad Massoumi-Bavil
Controlled Substance Registration - Physician
License number
01065755B
Date granted
08/19/2008
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Hammond Family Services, 5530 Hohman Avenue, Hammond IN 46320
indianalicensing.org
ID 5863940
LAST UPDATED 2026-06-04 03:22:08 UTC
LAST UPDATED 2026-06-04 03:22:08 UTC
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