License holder summary

Shane David Bush is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Shane David Bush is Porter Medical Group, 3630 Willowcreek Rd., Portage IN 46368. This licensed professional license is current. The license was granted 04/08/2013 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Shane David Bush
Controlled Substance Registration - Physician
License number
01071914B
Date granted
04/08/2013
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Porter Medical Group, 3630 Willowcreek Rd., Portage IN 46368
indianalicensing.org
ID 5911252
LAST UPDATED 2024-04-09 02:23:04 UTC

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