Indiana
Professional Licensing Agency
Mark Raymond Green
Controlled Substance Registration - Dentist
License number
12008310B
Date granted
11/30/1984
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
2201 LINCOLN WAY WEST, SOUTH BEND IN 46628
indianalicensing.org
ID 5123237
LAST UPDATED 2024-04-08 21:26:42 UTC
LAST UPDATED 2024-04-08 21:26:42 UTC
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