Indiana
Professional Licensing Agency
Kumpol Dennison
Controlled Substance Registration - Physician
License number
01024311B
Date granted
10/31/1985
Date expires
06/30/2003
Class
Controlled Substance Registration - Physician
Status
Expired
Address
103 WEST 86TH AVENUE, MERRILLVILLE IN 46410
indianalicensing.org
ID 5890838
LAST UPDATED 2024-04-11 20:02:12 UTC
LAST UPDATED 2024-04-11 20:02:12 UTC
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