Indiana
Professional Licensing Agency
Jacy Adam Nicholson
Controlled Substance Registration - Dentist
License number
12011947B
Date granted
05/22/2013
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
7120 S. US Highway 231, Huntingburg IN 47542
indianalicensing.org
ID 5126649
LAST UPDATED 2024-03-19 13:06:07 UTC
LAST UPDATED 2024-03-19 13:06:07 UTC
This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.