Indiana
Professional Licensing Agency
Charles D. Coburn
Controlled Substance Registration - Dentist
License number
12006381B
Date granted
11/30/1984
Date expires
03/01/2014
Class
Controlled Substance Registration - Dentist
Status
Expired
Address
60 Kilmartin Court, Valparaiso IN 46385-9304
indianalicensing.org
ID 5125884
LAST UPDATED 2024-05-01 12:38:23 UTC
LAST UPDATED 2024-05-01 12:38:23 UTC
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