Indiana
Professional Licensing Agency
Mark J. Noll
Controlled Substance Registration - Dentist
License number
12010479B
Date granted
10/18/2002
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
4041 Parnell Avenue, Fort Wayne IN 46805
indianalicensing.org
ID 5095321
LAST UPDATED 2024-04-16 08:35:01 UTC
LAST UPDATED 2024-04-16 08:35:01 UTC
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