Indiana
Professional Licensing Agency
Gordon Keith Green
Controlled Substance Registration - Dentist
License number
12007342B
Date granted
06/30/1986
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
P.O. Box 501, 147 East Broad Street, Lyons IN 47443-9502
indianalicensing.org
ID 5109484
LAST UPDATED 2024-03-14 16:34:00 UTC
LAST UPDATED 2024-03-14 16:34:00 UTC
This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.