Indiana
Professional Licensing Agency
Samuel M. Brubaker
Controlled Substance Registration - Physician
License number
01056996B
Date granted
09/08/2003
Date expires
06/30/2011
Class
Controlled Substance Registration - Physician
Status
Expired
Address
Tri County Surgical Associates, 430 B West Votaw St., Portland IN 47371
indianalicensing.org
ID 5911613
LAST UPDATED 2024-02-22 12:41:43 UTC
LAST UPDATED 2024-02-22 12:41:43 UTC
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