Robert Mark Blazekovich

Controlled Substance Registration - Dentist

Indiana  12009213B   Active

This Indiana license is held by Robert Mark Blazekovich. The license is currently active. It was granted on 01/10/1995 and expired on 03/01/2016

LICENSE DETAILS

  • License Number: 12009213B
  • Category: CSR-Dentist
  • Status: Active
  • Date Granted: 01/10/1995 (about 30 years ago)
  • Expiry Date: 03/01/2016 (about 9 years ago)

LOCATIONS

A Address

3655 Forest Court, Marion IN 46952