License holder summary

David Wood Douglas is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for David Wood Douglas is 4212 EAST MICHIGAN BOULEVARD, MICHIGAN CITY IN 46360. This licensed professional license is not current. The license was granted 01/06/1989 and expired on 03/01/1996.

Indiana

Professional Licensing Agency

David Wood Douglas
Controlled Substance Registration - Dentist
License number
12007853D
Date granted
01/06/1989
Date expires
03/01/1996
Class
Controlled Substance Registration - Dentist
Status
Expired
Address
4212 EAST MICHIGAN BOULEVARD, MICHIGAN CITY IN 46360
indianalicensing.org
ID 5111628
LAST UPDATED 2024-04-19 21:38:37 UTC

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