Indiana
Professional Licensing Agency
Niki J. Martine
Controlled Substance Registration - Dentist
License number
12009246B
Date granted
08/02/1990
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
7635 E. Stonegate Drive, Zionsville IN 46077
indianalicensing.org
ID 5103854
LAST UPDATED 2024-03-26 06:55:24 UTC
LAST UPDATED 2024-03-26 06:55:24 UTC
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