Indiana
Professional Licensing Agency
Douglas G. Whitehead
Controlled Substance Registration - Dentist
License number
12009055B
Date granted
07/06/1988
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
2120 N. 850 W. P.O. Box 848, Shipshewana IN 46565
indianalicensing.org
ID 5122406
LAST UPDATED 2024-03-23 10:12:55 UTC
LAST UPDATED 2024-03-23 10:12:55 UTC
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