Indiana
Professional Licensing Agency
Mary C. Baker
Controlled Substance Registration - Dentist
License number
12010697B
Date granted
01/25/2005
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
1101 S. Huntington St. Suite 4, Syracuse IN 46567
indianalicensing.org
ID 5124394
LAST UPDATED 2024-02-24 10:45:07 UTC
LAST UPDATED 2024-02-24 10:45:07 UTC
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