Indiana
Professional Licensing Agency
Stacy Cedric Johnson
Controlled Substance Registration - Dentist
License number
12010163B
Date granted
08/17/1999
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
Dentistry of Indiana, 2727 North High School Road, Indianapolis IN 46224-2911
indianalicensing.org
ID 5104472
LAST UPDATED 2024-03-20 11:49:30 UTC
LAST UPDATED 2024-03-20 11:49:30 UTC
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