Koushan Haidarzadeh Azad
Controlled Substance Registration - Dentist
Indiana 12011918B Active
This Indiana license is held by Koushan Haidarzadeh Azad. The license is currently active. It was granted on 03/13/2013 and expired on 03/01/2016
LICENSE DETAILS
- License Number: 12011918B
- Category: CSR-Dentist
- Status: Active
- Date Granted: 03/13/2013 (about 12 years ago)
- Expiry Date: 03/01/2016 (about 9 years ago)
LOCATIONS
A Address
Familia Dental, 5328 Coldwater Road, Fort Wayne IN 46825
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