Indiana
Professional Licensing Agency
David C. Gephardt
Controlled Substance Registration - Dentist
License number
12007469B
Date granted
06/30/1986
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
815 West 8th Street, Anderson IN 46016-1207
indianalicensing.org
ID 5080622
LAST UPDATED 2024-02-21 06:34:44 UTC
LAST UPDATED 2024-02-21 06:34:44 UTC
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