Indiana
Professional Licensing Agency
Diane Marie Hentz
Controlled Substance Registration - Physician
License number
01038843B
Date granted
11/13/1990
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Fort Wayne Dermatology Consultants, Inc, 5750 FALLS DRIVE, FORT WAYNE IN 46804
indianalicensing.org
ID 5853234
LAST UPDATED 2024-02-26 20:55:26 UTC
LAST UPDATED 2024-02-26 20:55:26 UTC
This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.