Indiana
Professional Licensing Agency
Jeanine Marie Green
Controlled Substance Registration - Dentist
License number
12009865B
Date granted
07/23/1996
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
1804 West Royale Drive, Muncie IN 47304-2243
indianalicensing.org
ID 5114097
LAST UPDATED 2024-04-25 16:14:43 UTC
LAST UPDATED 2024-04-25 16:14:43 UTC
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