Indiana
Professional Licensing Agency
Susan Elaine Wagner
Controlled Substance Registration - Dentist
License number
12008739B
Date granted
10/03/1985
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
8849 Shelby Street, Suite A2, Indianapolis IN 46227
indianalicensing.org
ID 5104554
LAST UPDATED 2024-04-02 15:14:37 UTC
LAST UPDATED 2024-04-02 15:14:37 UTC
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