Indiana
Professional Licensing Agency
Kingdon Kibble Brady
Controlled Substance Registration - Dentist
License number
12010038B
Date granted
06/29/1998
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
1040 Sagamore Parkway W., Ste. C, West Lafayette IN 47906
indianalicensing.org
ID 5127680
LAST UPDATED 2024-03-05 03:33:15 UTC
LAST UPDATED 2024-03-05 03:33:15 UTC
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