License holder summary

David Van Wormer is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for David Van Wormer is 312 North Lake Street, Warsaw IN 46580-2643. This licensed professional license is current. The license was granted 08/01/1996 and expired on 03/01/2016.

Indiana

Professional Licensing Agency

David Van Wormer
Controlled Substance Registration - Dentist
License number
12009888B
Date granted
08/01/1996
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
312 North Lake Street, Warsaw IN 46580-2643
indianalicensing.org
ID 5127104
LAST UPDATED 2024-04-21 13:06:38 UTC

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