Indiana
Professional Licensing Agency
Andrew Lane
Controlled Substance Registration - Dentist
License number
12010414B
Date granted
04/10/2002
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
INDIANA HEALTH CENTERS INC, 3118 S LAFOUNTAIN, Kokomo IN 46902
indianalicensing.org
ID 5106154
LAST UPDATED 2024-03-10 22:26:50 UTC
LAST UPDATED 2024-03-10 22:26:50 UTC
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