Indiana
Professional Licensing Agency
Thomas M. Konnersman
Controlled Substance Registration - Dentist
License number
12007760B
Date granted
07/31/1986
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
22131 Main Street, Oldenburg IN 47036
indianalicensing.org
ID 5117352
LAST UPDATED 2024-02-27 01:33:29 UTC
LAST UPDATED 2024-02-27 01:33:29 UTC
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