License holder summary

SEVERINO G GOMILLA is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for SEVERINO G GOMILLA is 727 MOON ROAD, PLAINFIELD IN 46168. This licensed professional license is not current. The license was granted 05/24/1994 and expired on 06/30/1995.

Indiana

Professional Licensing Agency

SEVERINO G GOMILLA
Controlled Substance Registration - Physician
License number
01022484B
Date granted
05/24/1994
Date expires
06/30/1995
Class
Controlled Substance Registration - Physician
Status
Revoked
Address
727 MOON ROAD, PLAINFIELD IN 46168
indianalicensing.org
ID 5910307
LAST UPDATED 2024-03-27 00:13:22 UTC

This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.

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