Indiana
Professional Licensing Agency
Mark Anthony Bustamante
Temporary Medical Doctor Permit
License number
99054948A
Date granted
11/30/2012
Date expires
02/28/2013
Class
Temporary Medical Doctor Permit
Status
Superceded
Address
Indianapolis IN 46236
indianalicensing.org
ID 12002828
LAST UPDATED 2024-01-04 19:19:55 UTC
LAST UPDATED 2024-01-04 19:19:55 UTC
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