Indiana
Professional Licensing Agency
Christian J. Mazur
Controlled Substance Registration - Dentist
License number
12010269B
Date granted
07/11/2000
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
821 Twyckenham Boulevard, Lafayette IN 47909-6760
indianalicensing.org
ID 5107331
LAST UPDATED 2024-03-27 00:52:21 UTC
LAST UPDATED 2024-03-27 00:52:21 UTC
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