Indiana
Professional Licensing Agency
Richard Dale Ellsworth
Controlled Substance Registration - Dentist
License number
12007107B
Date granted
07/24/1985
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
150 PROFESSIONAL COURT, LAFAYETTE IN 47905
indianalicensing.org
ID 5107819
LAST UPDATED 2024-02-04 20:06:17 UTC
LAST UPDATED 2024-02-04 20:06:17 UTC
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