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 2024-03-07 23:03:17 UTC
LAST UPDATED 2024-03-07 23:03:17 UTC
This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.