Indiana
Professional Licensing Agency
J. Keith Roberts
Controlled Substance Registration - Dentist
License number
12005978B
Date granted
08/31/1986
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
828 AUTO MALL ROAD, BLOOMINGTON IN 47401
indianalicensing.org
ID 5083067
LAST UPDATED 2024-04-05 04:46:47 UTC
LAST UPDATED 2024-04-05 04:46:47 UTC
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