License holder summary

Randall Joseph Brucken is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Randall Joseph Brucken is 3711 Rome Drive, Suite A, Lafayette IN 47905-4426. This licensed professional license is current. The license was granted 08/13/1999 and expired on 03/01/2016.

Indiana

Professional Licensing Agency

Randall Joseph Brucken
Controlled Substance Registration - Dentist
License number
12010142B
Date granted
08/13/1999
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
3711 Rome Drive, Suite A, Lafayette IN 47905-4426
indianalicensing.org
ID 5107800
LAST UPDATED 2024-04-23 18:33:25 UTC

This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.

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