Indiana
Professional Licensing Agency
Amy E. Brockman
Controlled Substance Registration - Dentist
License number
12010934B
Date granted
02/07/2007
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
Allcare Dental, 170 Creasy Ln., Lafayette IN 47905
indianalicensing.org
ID 5107311
LAST UPDATED 2024-02-22 21:57:48 UTC
LAST UPDATED 2024-02-22 21:57:48 UTC
This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.