Indiana
Professional Licensing Agency
Mystie Samantha Pieters
Controlled Substance Registration - Dentist
License number
12010411B
Date granted
11/05/2001
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
Chesterton Family Dentistry, 751 E. Porter Ave, Suite 1, Chesterton IN 46304
indianalicensing.org
ID 5126248
LAST UPDATED 2024-05-01 16:07:43 UTC
LAST UPDATED 2024-05-01 16:07:43 UTC
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