Indiana
Professional Licensing Agency
Mark Wallace Smith
Controlled Substance Registration - Dentist
License number
12007415B
Date granted
11/30/1985
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
7650 East State Road 252, Edinburgh IN 46124
indianalicensing.org
ID 5090495
LAST UPDATED 2024-04-02 08:45:47 UTC
LAST UPDATED 2024-04-02 08:45:47 UTC
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