Indiana
Professional Licensing Agency
Mary Anne Bain
Controlled Substance Registration - Dentist
License number
12007971B
Date granted
07/31/1986
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
278 Manchester Avenue, Wabash IN 46992
indianalicensing.org
ID 5126811
LAST UPDATED 2024-01-29 03:30:43 UTC
LAST UPDATED 2024-01-29 03:30:43 UTC
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