Indiana
Professional Licensing Agency
Michael L. Bagnoli
Controlled Substance Registration - Dentist
License number
12008541B
Date granted
04/14/1988
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
OMS Center of Lafayette, 2020 Union Street, Suite 200, Lafayette IN 47904
indianalicensing.org
ID 5107718
LAST UPDATED 2024-03-05 01:49:53 UTC
LAST UPDATED 2024-03-05 01:49:53 UTC
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