Mark William Bantz
Controlled Substance Registration - Dentist
Indiana 12007086B Expired
This Indiana license was held by Mark William Bantz. The license is no longer active. It was granted on 06/23/1999 and expired on 03/01/2014
LICENSE DETAILS
- License Number: 12007086B
- Category: CSR-Dentist
- Status: Expired
- Date Granted: 06/23/1999 (about 26 years ago)
- Expiry Date: 03/01/2014 (over 11 years ago)
LOCATIONS
A Address
820 East Colfax Avenue, South Bend IN 46617-2804