Indiana
Professional Licensing Agency
Mariquita Palanca-Beveridge
Controlled Substance Registration - Dentist
License number
12009522B
Date granted
07/21/1994
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
8280 North Michigan Road Suite A, Indianapolis IN 46268
indianalicensing.org
ID 5103483
LAST UPDATED 2024-04-28 19:45:00 UTC
LAST UPDATED 2024-04-28 19:45:00 UTC
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