Indiana
Professional Licensing Agency
Matthew David Haller
Controlled Substance Registration - Dentist
License number
12008792B
Date granted
08/08/1986
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
1220 Mdeical Park Drive, Building 2, Fort Wayne IN 46825
indianalicensing.org
ID 5095374
LAST UPDATED 2024-01-18 16:51:56 UTC
LAST UPDATED 2024-01-18 16:51:56 UTC
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