Indiana
Professional Licensing Agency
Brett Anthony Henrikson
Controlled Substance Registration - Dentist
License number
12010155B
Date granted
04/13/2004
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
Lafayette Oral & Maxillofacial Surgery Group P.C., 953 Park East Boulevard Suite A, Lafayette IN 47905-4878
indianalicensing.org
ID 5107317
LAST UPDATED 2024-02-09 21:35:20 UTC
LAST UPDATED 2024-02-09 21:35:20 UTC
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