Indiana
Professional Licensing Agency
Ken A. Beckerman
Controlled Substance Registration - Dentist
License number
12007838B
Date granted
07/31/1986
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
Tulip Tree Family Health Care, 123 North McCreary Street, Fort Branch IN 47648
indianalicensing.org
ID 5094079
LAST UPDATED 2024-03-25 06:22:30 UTC
LAST UPDATED 2024-03-25 06:22:30 UTC
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