Indiana
Professional Licensing Agency
Mark Weiler Tatman
Controlled Substance Registration - Dentist
License number
12007528B
Date granted
06/30/1986
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
110 West North Street, Portland IN 47371
indianalicensing.org
ID 5119240
LAST UPDATED 2024-05-11 18:20:35 UTC
LAST UPDATED 2024-05-11 18:20:35 UTC
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