Indiana
Professional Licensing Agency
Rebecca P. Bolon
Controlled Substance Registration - Dentist
License number
12009069B
Date granted
05/09/1991
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
9311 North Meridian, Suite 200, Indianapolis IN 46260
indianalicensing.org
ID 5103997
LAST UPDATED 2024-05-05 13:58:59 UTC
LAST UPDATED 2024-05-05 13:58:59 UTC
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