Indiana
Professional Licensing Agency
Edward T. Mamaril
Controlled Substance Registration - Dentist
License number
12008594B
Date granted
07/31/1986
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
2302 South Dixon Road, Suite 125, Kokomo IN 46902
indianalicensing.org
ID 5106333
LAST UPDATED 2024-03-11 15:34:05 UTC
LAST UPDATED 2024-03-11 15:34:05 UTC
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