License holder summary

Catherine N Periolat is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Catherine N Periolat is 4317 Huntley Court, Fort Wayne IN 46814-9797. This licensed professional license is current. The license was granted 07/30/1996 and expired on 03/01/2016.

Indiana

Professional Licensing Agency

Catherine N Periolat
Controlled Substance Registration - Dentist
License number
12009882B
Date granted
07/30/1996
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
4317 Huntley Court, Fort Wayne IN 46814-9797
indianalicensing.org
ID 5094263
LAST UPDATED 2024-02-27 02:02:39 UTC

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