Indiana
Professional Licensing Agency
T. Ryan Jackson
Controlled Substance Registration - Dentist
License number
12009768B
Date granted
07/17/1995
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
622 North Madison Avenue, Greenwood IN 46142
indianalicensing.org
ID 5099590
LAST UPDATED 2024-04-24 14:27:34 UTC
LAST UPDATED 2024-04-24 14:27:34 UTC
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