Indiana
Professional Licensing Agency
Lisa Jane Baker
Controlled Substance Registration - Dentist
License number
12009106B
Date granted
07/06/1989
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
4217 EAST THIRD STREET, BLOOMINGTON IN 47401
indianalicensing.org
ID 5083289
LAST UPDATED 2024-04-04 07:39:19 UTC
LAST UPDATED 2024-04-04 07:39:19 UTC
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