Indiana
Professional Licensing Agency
Henri Renom De La Baume
Controlled Substance Registration - Physician
License number
01059513B
Date granted
07/13/2004
Date expires
06/30/2005
Class
Controlled Substance Registration - Physician
Status
Expired
Address
G I Physicians Group, 3611 South Reed Rd, Ste 211, Kokomo IN 46902
indianalicensing.org
ID 5876147
LAST UPDATED 2024-03-25 07:00:19 UTC
LAST UPDATED 2024-03-25 07:00:19 UTC
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