Indiana
Professional Licensing Agency
John Russell Phelps
Controlled Substance Registration - Dentist
License number
12009486B
Date granted
11/08/1993
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
8902 North Meridian Street, Suite 139, Indianapolis IN 46260
indianalicensing.org
ID 5103029
LAST UPDATED 2024-03-17 05:17:26 UTC
LAST UPDATED 2024-03-17 05:17:26 UTC
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