License holder summary

Eugene Theodore Kwiecien is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Eugene Theodore Kwiecien is 6882 West Johnson Road, La Porte IN 46350. This licensed professional license is current. The license was granted 05/31/1986 and expired on 03/01/2016.

Indiana

Professional Licensing Agency

Eugene Theodore Kwiecien
Controlled Substance Registration - Dentist
License number
12006674B
Date granted
05/31/1986
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
6882 West Johnson Road, La Porte IN 46350
indianalicensing.org
ID 5107105
LAST UPDATED 2024-05-06 16:59:14 UTC

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