License holder summary

David A. Wagner is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for David A. Wagner is 4656 WEST JEFFERSON SUITE 285, FORT WAYNE IN 46804. This licensed professional license is not current. The license was granted 09/30/1986 and expired on 03/01/2000.

Indiana

Professional Licensing Agency

David A. Wagner
Controlled Substance Registration - Dentist
License number
12007186B
Date granted
09/30/1986
Date expires
03/01/2000
Class
Controlled Substance Registration - Dentist
Status
Expired
Address
4656 WEST JEFFERSON SUITE 285, FORT WAYNE IN 46804
indianalicensing.org
ID 5094408
LAST UPDATED 2024-04-06 18:14:41 UTC

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