Indiana
Professional Licensing Agency
Timothy O. Willis
Controlled Substance Registration - Dentist
License number
12007712B
Date granted
07/31/1986
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
444 North Flynn Road, Westville IN 46391
indianalicensing.org
ID 5128033
LAST UPDATED 2024-03-26 10:55:58 UTC
LAST UPDATED 2024-03-26 10:55:58 UTC
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