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 2026-06-08 23:58:15 UTC
LAST UPDATED 2026-06-08 23:58:15 UTC
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