Indiana
Professional Licensing Agency
Michael Louis Iczkovitz
Controlled Substance Registration - Dentist
License number
12008664C
Date granted
06/29/2000
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
Midwest Oral & Maxillofacial Surgery, 516 North Line Street, Columbia City IN 46725-1230
indianalicensing.org
ID 5087492
LAST UPDATED 2024-02-16 16:23:05 UTC
LAST UPDATED 2024-02-16 16:23:05 UTC
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