Indiana
Professional Licensing Agency
Thomas R. Clark
Controlled Substance Registration - Dentist
License number
12007845B
Date granted
09/30/1986
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
3410 W. Purdue Ave., Muncie IN 47304
indianalicensing.org
ID 5114411
LAST UPDATED 2024-04-07 05:30:00 UTC
LAST UPDATED 2024-04-07 05:30:00 UTC
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