Indiana
Professional Licensing Agency
Trang Mai
Controlled Substance Registration - Dentist
License number
12010453B
Date granted
07/23/2002
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
1637 Portage Avenue, South Bend IN 46616
indianalicensing.org
ID 5123741
LAST UPDATED 2024-04-22 20:12:38 UTC
LAST UPDATED 2024-04-22 20:12:38 UTC
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