Indiana
Professional Licensing Agency
Michael A. Boldry
Controlled Substance Registration - Dentist
License number
12007092B
Date granted
03/01/1988
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
1014 Madison Street, Rochester IN 46975-1830
indianalicensing.org
ID 5120279
LAST UPDATED 2024-04-17 22:48:56 UTC
LAST UPDATED 2024-04-17 22:48:56 UTC
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