Amanda Marie Blackmon
Controlled Substance Registration - Dentist
Indiana 12011504B Expired
This Indiana license was held by Amanda Marie Blackmon. The license is no longer active. It was granted on 08/11/2010 and expired on 03/01/2012
LICENSE DETAILS
- License Number: 12011504B
- Category: CSR-Dentist
- Status: Expired
- Date Granted: 08/11/2010 (about 16 years ago)
- Expiry Date: 03/01/2012 (over 14 years ago)
LOCATIONS
A Address
Aspen Dental, 2124 East Bouleavard Street, Kokomo IN 46902