Indiana
Professional Licensing Agency
Daniel Jordan Berquist
Controlled Substance Registration - Dentist
License number
12012019B
Date granted
07/12/2013
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
11059 Broadway, Ste B, Crown Point IN 46307
indianalicensing.org
ID 5088839
LAST UPDATED 2024-04-26 13:34:04 UTC
LAST UPDATED 2024-04-26 13:34:04 UTC
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