Indiana
Professional Licensing Agency
Benjamin J. Clinkenbeard
Controlled Substance Registration - Dentist
License number
12010541B
Date granted
07/07/2003
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
6409 Georgetown North Blvd, Fort Wayne IN 46815
indianalicensing.org
ID 5094154
LAST UPDATED 2026-05-18 09:20:55 UTC
LAST UPDATED 2026-05-18 09:20:55 UTC
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