Indiana
Professional Licensing Agency
Mukuka Kapilikisha
Controlled Substance Registration - Dentist
License number
12011216B
Date granted
08/19/2008
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
7880 Broadway, Suite A, Merrillville IN 46410
indianalicensing.org
ID 5111223
LAST UPDATED 2024-04-13 16:27:23 UTC
LAST UPDATED 2024-04-13 16:27:23 UTC
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