Indiana
Professional Licensing Agency
Farzana Poyan
Controlled Substance Registration - Dentist
License number
12010648B
Date granted
09/08/2004
Date expires
03/01/2014
Class
Controlled Substance Registration - Dentist
Status
Expired
Address
10439 East US 36, Avon IN 46123
indianalicensing.org
ID 5081868
LAST UPDATED 2024-01-31 17:15:39 UTC
LAST UPDATED 2024-01-31 17:15:39 UTC
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