Indiana
Professional Licensing Agency
Kurian Mathew
Controlled Substance Registration - Dentist
License number
12012091B
Date granted
06/04/2014
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
Destiny Dental, 1738 165th Street, Hammond IN 46320
indianalicensing.org
ID 27545667
LAST UPDATED 2024-03-22 15:38:01 UTC
LAST UPDATED 2024-03-22 15:38:01 UTC
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