Indiana
Professional Licensing Agency
Amanda Greenlee Bourff
Controlled Substance Registration - Dentist
License number
12010671B
Date granted
07/14/2004
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
2179 North Morton Street, Franklin IN 46131
indianalicensing.org
ID 5096856
LAST UPDATED 2024-04-26 05:57:03 UTC
LAST UPDATED 2024-04-26 05:57:03 UTC
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