Indiana
Professional Licensing Agency
Nse Ekpenyong
Controlled Substance Registration - Dentist
License number
12011915B
Date granted
02/11/2013
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
Destiny Dental, 1738 165th Street, Hammond IN 46320
indianalicensing.org
ID 5100069
LAST UPDATED 2026-04-25 17:38:33 UTC
LAST UPDATED 2026-04-25 17:38:33 UTC
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