Indiana
Professional Licensing Agency
Diane Danner Bagnoli
Controlled Substance Registration - Dentist
License number
12008563B
Date granted
07/14/1988
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
500 North 26th Street, Lafayette IN 47904
indianalicensing.org
ID 5107420
LAST UPDATED 2024-04-01 07:54:38 UTC
LAST UPDATED 2024-04-01 07:54:38 UTC
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