Indiana
Professional Licensing Agency
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 5107433
LAST UPDATED 2024-02-10 18:33:27 UTC
LAST UPDATED 2024-02-10 18:33:27 UTC
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