Indiana
Professional Licensing Agency
Andy Koultourides
Controlled Substance Registration - Dentist
License number
12009245B
Date granted
08/02/1990
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
619 RIDGE RAOD, MUNSTER IN 46321
indianalicensing.org
ID 5114523
LAST UPDATED 2024-02-25 21:48:46 UTC
LAST UPDATED 2024-02-25 21:48:46 UTC
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