Bruce A. Blackburn
Controlled Substance Registration - Dentist
Indiana 12007761B Active
This Indiana license is held by Bruce A. Blackburn. The license is currently active. It was granted on 07/31/1986 and expired on 03/01/2016
LICENSE DETAILS
- License Number: 12007761B
- Category: CSR-Dentist
- Status: Active
- Date Granted: 07/31/1986 (about 40 years ago)
- Expiry Date: 03/01/2016 (over 10 years ago)
LOCATIONS
A Address
200 South Dixon Road, Kokomo IN 46901
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