Indiana
Professional Licensing Agency
Nancy Helen Burkhardt
Controlled Substance Registration - Dentist
License number
12009475B
Date granted
07/31/1995
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
Madison State Hospital, 711 Green Road, Madison IN 47250-2143
indianalicensing.org
ID 5109741
LAST UPDATED 2024-04-19 16:41:44 UTC
LAST UPDATED 2024-04-19 16:41:44 UTC
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