Indiana
Professional Licensing Agency
Philip Lee Nicholson
Controlled Substance Registration - Dentist
License number
12007371B
Date granted
06/21/1976
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
150 INDIANA STREET, MOORESVILLE IN 46158
indianalicensing.org
ID 5113340
LAST UPDATED 2024-02-08 06:01:38 UTC
LAST UPDATED 2024-02-08 06:01:38 UTC
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