Indiana
Professional Licensing Agency
Mark Duane Shafer
Controlled Substance Registration - Dentist
License number
12009526C
Date granted
03/19/1997
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
51410 Bittersweet Road, Granger IN 46530
indianalicensing.org
ID 5098421
LAST UPDATED 2024-03-17 22:15:41 UTC
LAST UPDATED 2024-03-17 22:15:41 UTC
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