License holder summary

EDGAR KENNETH DEJEAN is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for EDGAR KENNETH DEJEAN is 1888 NORTH STATE ROAD 135, SALEM IN 47167. This licensed professional license is not current. The license was granted 10/31/1984 and expired on 03/01/1996.

Indiana

Professional Licensing Agency

EDGAR KENNETH DEJEAN
Controlled Substance Registration - Dentist
License number
12004509B
Date granted
10/31/1984
Date expires
03/01/1996
Class
Controlled Substance Registration - Dentist
Status
Expired
Address
1888 NORTH STATE ROAD 135, SALEM IN 47167
indianalicensing.org
ID 5121203
LAST UPDATED 2024-01-15 07:56:22 UTC

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