License holder summary

Derek Marcus Stephens is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Derek Marcus Stephens is 637 SOUTH LAKE ST, GARY IN IN 46403. This licensed professional license is not current. The license was granted 01/31/1986 and expired on 01/31/1987.

Indiana

Professional Licensing Agency

Derek Marcus Stephens
Controlled Substance Registration - Dentist
License number
12008151B
Date granted
01/31/1986
Date expires
01/31/1987
Class
Controlled Substance Registration - Dentist
Status
Expired
Address
637 SOUTH LAKE ST, GARY IN IN 46403
indianalicensing.org
ID 5097407
LAST UPDATED 2024-04-04 08:10:05 UTC

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