Frederick Larsen
Controlled Substance Registration - Dentist
Indiana 12007686B Suspended
This Indiana license was held by Frederick Larsen. The license is no longer active. It was granted on 06/19/1991 and expired on 03/01/1994
LICENSE DETAILS
- License Number: 12007686B
- Category: CSR-Dentist
- Status: Suspended
- Date Granted: 06/19/1991 (almost 33 years ago)
- Expiry Date: 03/01/1994 (about 30 years ago)
LOCATIONS
A Address
110 E VAN TREES ST, WASHINGTON IN 47501