Indiana
Professional Licensing Agency
Jada M. Roberts
Controlled Substance Registration - Dentist
License number
12012082B
Date granted
07/11/2014
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
Three Rivers Family Dental, 2828 E. State Blvd. Suite B, Fort Wayne IN 46805
indianalicensing.org
ID 27545580
LAST UPDATED 2024-04-20 10:20:37 UTC
LAST UPDATED 2024-04-20 10:20:37 UTC
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