Indiana
Professional Licensing Agency
Borys Averbukh
Controlled Substance Registration - Dentist
License number
12012238B
Date granted
10/01/2014
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 27545574
LAST UPDATED 2024-03-27 22:50:40 UTC
LAST UPDATED 2024-03-27 22:50:40 UTC
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