Mark Leslie Johnson

Controlled Substance Registration - Dentist

Indiana  12007250B   Expired

This Indiana license was held by Mark Leslie Johnson. The license is no longer active. It was granted on 07/31/1986 and expired on 03/01/1990

LICENSE DETAILS

  • License Number: 12007250B
  • Category: CSR-Dentist
  • Status: Expired
  • Date Granted: 07/31/1986 (over 38 years ago)
  • Expiry Date: 03/01/1990 (about 35 years ago)

LOCATIONS

A Address

VETERANS ADMIN HOSP-DENT DEPT, EAST 38TH STREET, MARION IN 46952