License holder summary

Roger Paul Valliere is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Roger Paul Valliere is 1330 East State Blvd., Fort Wayne IN 46805-4422. This licensed professional license is current. The license was granted 06/20/2000 and expired on 03/01/2016.

Indiana

Professional Licensing Agency

Roger Paul Valliere
Controlled Substance Registration - Dentist
License number
12010249B
Date granted
06/20/2000
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
1330 East State Blvd., Fort Wayne IN 46805-4422
indianalicensing.org
ID 5095794
LAST UPDATED 2024-02-24 14:56:16 UTC

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