License holder summary

Colleen Ann Baines is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Colleen Ann Baines is 103 Farabee Drive North Suite B, Lafayette IN 47905-5915. This licensed professional license is current. The license was granted 07/27/2000 and expired on 03/01/2016.

Indiana

Board of Licensing

Colleen Ann Baines
Controlled Substance Registration - Dentist
License number
12010256B
Date granted
07/27/2000
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
103 Farabee Drive North Suite B, Lafayette IN 47905-5915
indianalicensing.org
ID 22437760
LAST UPDATED 2020-12-11 18:52:05 UTC

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