Indiana
Professional Licensing Agency
Phil Noble Ruckman, III
Controlled Substance Registration - Dentist
License number
12011439B
Date granted
06/01/2010
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
Georgetown North Dental Group, 6405 Georgetown North Blvd., Fort Wayne IN 46815-7007
indianalicensing.org
ID 5095586
LAST UPDATED 2024-05-03 05:06:40 UTC
LAST UPDATED 2024-05-03 05:06:40 UTC
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