Indiana
Professional Licensing Agency
Wendy Diann Maple
Controlled Substance Registration - Dentist
License number
12010584B
Date granted
10/27/2003
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
718 E. Broadway, Logansport IN 46947
indianalicensing.org
ID 5109274
LAST UPDATED 2024-04-02 05:12:12 UTC
LAST UPDATED 2024-04-02 05:12:12 UTC
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