Indiana
Professional Licensing Agency
Gene A. Bourgasser
Controlled Substance Registration - Physician
License number
01030642B
Date granted
03/31/1986
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Sullivan Family Practice, LLC, 2229 Mary Sherman Drive-P O Box 230, Sullivan IN 47882
indianalicensing.org
ID 5923347
LAST UPDATED 2024-04-28 18:52:31 UTC
LAST UPDATED 2024-04-28 18:52:31 UTC
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