Indiana
Professional Licensing Agency
John Constantinos Mantinaos
Controlled Substance Registration - Dentist
License number
12011569B
Date granted
12/16/2010
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
Kool Smiles IN-3, PC, 1021 West 5th Avenue, Gary IN 46402
indianalicensing.org
ID 5097551
LAST UPDATED 2024-05-03 19:00:49 UTC
LAST UPDATED 2024-05-03 19:00:49 UTC
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