License holder summary

Gautam Krishnaknat Shah is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Gautam Krishnaknat Shah is ST MARGERT MERCY HOSPITAL, 5454 HOHMAN AVENUE, HAMMOND IN 46320. This licensed professional license is current. The license was granted 06/30/1985 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Gautam Krishnaknat Shah
Controlled Substance Registration - Physician
License number
01029220B
Date granted
06/30/1985
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
ST MARGERT MERCY HOSPITAL, 5454 HOHMAN AVENUE, HAMMOND IN 46320
indianalicensing.org
ID 5863991
LAST UPDATED 2024-02-24 20:54:11 UTC

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