Indiana
Professional Licensing Agency
Jennifer Secrest Board
Controlled Substance Registration - Dentist
License number
12010855B
Date granted
06/27/2006
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
1300 Old Hwy. 135 NE, Corydon IN 47112
indianalicensing.org
ID 5088384
LAST UPDATED 2026-03-24 15:15:14 UTC
LAST UPDATED 2026-03-24 15:15:14 UTC
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