Indiana
Professional Licensing Agency
Patricia Humphrey Clark
Controlled Substance Registration - Dentist
License number
12007844B
Date granted
07/31/1986
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
221 SOUTH 19TH STREET, TERRE HAUTE IN 47807
indianalicensing.org
ID 5125244
LAST UPDATED 2024-04-19 04:16:09 UTC
LAST UPDATED 2024-04-19 04:16:09 UTC
This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.