Indiana
Professional Licensing Agency
Scott W Martinsen
Controlled Substance Registration - Dentist
License number
12007494B
Date granted
07/31/1986
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
1011 Michican Avenue, La Porte IN 46350-3506
indianalicensing.org
ID 5107294
LAST UPDATED 2024-03-28 05:07:50 UTC
LAST UPDATED 2024-03-28 05:07:50 UTC
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