Indiana
Professional Licensing Agency
Kimberly J. Bachmann
Controlled Substance Registration - Dentist
License number
12010600B
Date granted
11/14/2003
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
4949 East Poplar Street, Terre Haute IN 47803
indianalicensing.org
ID 5125034
LAST UPDATED 2024-04-04 14:15:10 UTC
LAST UPDATED 2024-04-04 14:15:10 UTC
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