License holder summary

Douglas John Kosek is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Douglas John Kosek is 413 West Jefferson Boulevard, South Bend IN 46601-1514. This licensed professional license is current. The license was granted 08/19/1996 and expired on 03/01/2016.

Indiana

Professional Licensing Agency

Douglas John Kosek
Controlled Substance Registration - Dentist
License number
12009873B
Date granted
08/19/1996
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
413 West Jefferson Boulevard, South Bend IN 46601-1514
indianalicensing.org
ID 5122900
LAST UPDATED 2024-03-28 23:26:33 UTC

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