Indiana
Professional Licensing Agency
Matthew C. Moll
Controlled Substance Registration - Dentist
License number
12010101B
Date granted
04/12/1999
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
125 North Shortridge Road, Indianapolis IN 46219-4908
indianalicensing.org
ID 5103537
LAST UPDATED 2024-02-06 22:44:12 UTC
LAST UPDATED 2024-02-06 22:44:12 UTC
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