License holder summary

Brent Lee Ellis is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Brent Lee Ellis is P O BOX 635, HWY 54 EAST SUBURAN PLAZA, LINTON IN 47441. This licensed professional license is current. The license was granted 03/01/1988 and expired on 03/01/2016.

Indiana

Professional Licensing Agency

Brent Lee Ellis
Controlled Substance Registration - Dentist
License number
12008690B
Date granted
03/01/1988
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
P O BOX 635, HWY 54 EAST SUBURAN PLAZA, LINTON IN 47441
indianalicensing.org
ID 5109038
LAST UPDATED 2024-05-02 02:52:02 UTC

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