Indiana
Professional Licensing Agency
Wallace Eugene Bash
Controlled Substance Registration - Physician
License number
01013971B
Date granted
04/30/1986
Date expires
06/30/2001
Class
Controlled Substance Registration - Physician
Status
Expired
Address
6770 Covington Creek Trail, Fort Wayne IN 46804
indianalicensing.org
ID 5854703
LAST UPDATED 2024-05-07 08:20:34 UTC
LAST UPDATED 2024-05-07 08:20:34 UTC
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