Indiana
Professional Licensing Agency
Hayley Heckman Pavlov
Controlled Substance Registration - Dentist
License number
12010602B
Date granted
06/14/2004
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
3158 North National Rd., Columbus IN 47201
indianalicensing.org
ID 5087803
LAST UPDATED 2024-03-09 11:57:48 UTC
LAST UPDATED 2024-03-09 11:57:48 UTC
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