Indiana
Professional Licensing Agency
Shannon K. Bader
Controlled Substance Registration - Physician
License number
01031401B
Date granted
11/30/1986
Date expires
10/31/2013
Class
Controlled Substance Registration - Physician
Status
Expired
Address
8550 Broadway, Merrillville IN 46410
indianalicensing.org
ID 5891629
LAST UPDATED 2024-03-16 06:55:16 UTC
LAST UPDATED 2024-03-16 06:55:16 UTC
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