Indiana
Professional Licensing Agency
Alysha R. Moll
Controlled Substance Registration - Dentist
License number
12012154B
Date granted
07/08/2014
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
Familia Dental, 5328 Coldwater Rd, Fort Wayne IN 46825
indianalicensing.org
ID 27545573
LAST UPDATED 2026-05-03 02:21:13 UTC
LAST UPDATED 2026-05-03 02:21:13 UTC
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