License holder summary

Bruce A. Blackburn is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Bruce A. Blackburn is 200 South Dixon Road, Kokomo IN 46901. This licensed professional license is current. The license was granted 07/31/1986 and expired on 03/01/2016.

Indiana

Professional Licensing Agency

Bruce A. Blackburn
Controlled Substance Registration - Dentist
License number
12007761B
Date granted
07/31/1986
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
200 South Dixon Road, Kokomo IN 46901
indianalicensing.org
ID 5106176
LAST UPDATED 2024-02-14 08:45:11 UTC

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