Indiana
Professional Licensing Agency
Kristen Melissa Beavers
Controlled Substance Registration - Dentist
License number
12010891B
Date granted
09/11/2006
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
6555 Quail Run, Fishers IN 46038-4646
indianalicensing.org
ID 5093497
LAST UPDATED 2024-03-12 11:44:13 UTC
LAST UPDATED 2024-03-12 11:44:13 UTC
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