License holder summary

Mariellen Dentino is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Mariellen Dentino is 1312 PROFESSIONAL BOULEVARD STE 200, Evansville IN 47714. This licensed professional license is current. The license was granted 08/31/1986 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Mariellen Dentino
Controlled Substance Registration - Physician
License number
01024941B
Date granted
08/31/1986
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
1312 PROFESSIONAL BOULEVARD STE 200, Evansville IN 47714
indianalicensing.org
ID 5850579
LAST UPDATED 2024-03-21 20:54:37 UTC

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