Indiana
Professional Licensing Agency
Mouhammad Bassel Ericsoussi
Controlled Substance Registration - Physician
License number
01069620B
Date granted
11/04/2011
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Franciscan Medical Specialists, 5529 Hohman Avenue, Hammond IN 46320
indianalicensing.org
ID 5864739
LAST UPDATED 2024-02-13 08:48:57 UTC
LAST UPDATED 2024-02-13 08:48:57 UTC
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