Indiana
Professional Licensing Agency
Anthony Di Costanzo
Controlled Substance Registration - Dentist
License number
12007851B
Date granted
03/27/1985
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
1123 Joliet Street, Dyer IN 46311
indianalicensing.org
ID 5089876
LAST UPDATED 2024-02-17 00:36:07 UTC
LAST UPDATED 2024-02-17 00:36:07 UTC
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