Indiana
Professional Licensing Agency
J. D. Kisella
Controlled Substance Registration - Dentist
License number
12009359B
Date granted
06/05/2001
Date expires
03/01/2006
Class
Controlled Substance Registration - Dentist
Status
Expired
Address
ORAL AND FACIAL COSMETIC SURGERY CENTER, 1612 NORTH BALDWIN AVENUE, Marion IN 46952
indianalicensing.org
ID 5110113
LAST UPDATED 2024-02-14 18:03:57 UTC
LAST UPDATED 2024-02-14 18:03:57 UTC
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