Indiana
Professional Licensing Agency
John S. Frazee
Controlled Substance Registration - Dentist
License number
12010677B
Date granted
10/13/2004
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
Indiana State Prison, 1 Park Row ATTN Dental Clinic, Michigan City IN 46360
indianalicensing.org
ID 5111816
LAST UPDATED 2024-05-03 14:48:26 UTC
LAST UPDATED 2024-05-03 14:48:26 UTC
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