Indiana
Professional Licensing Agency
Lena Birgitta Fermback
Controlled Substance Registration - Dentist
License number
12008691B
Date granted
08/29/1985
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
1010 South Union Street, Warsaw IN 46580-4706
indianalicensing.org
ID 5127177
LAST UPDATED 2024-03-10 21:07:04 UTC
LAST UPDATED 2024-03-10 21:07:04 UTC
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