Indiana
Professional Licensing Agency
Jenna Marie Davies
Controlled Substance Registration - Dentist
License number
12012035B
Date granted
08/06/2013
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
Birchwood Family Dental, 1375 S. Lebanon Street, Suite 200, Lebanon IN 46052
indianalicensing.org
ID 5108622
LAST UPDATED 2024-04-22 09:28:55 UTC
LAST UPDATED 2024-04-22 09:28:55 UTC
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