License holder summary

Emery John Spisak, Jr. is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Emery John Spisak, Jr. is 1320 Medical Park Drive, Fort Wayne IN 46825. This licensed professional license is not current. The license was granted 06/30/1986 and expired on 03/01/2014.

Indiana

Professional Licensing Agency

Emery John Spisak, Jr.
Controlled Substance Registration - Dentist
License number
12006332B
Date granted
06/30/1986
Date expires
03/01/2014
Class
Controlled Substance Registration - Dentist
Status
Expired
Address
1320 Medical Park Drive, Fort Wayne IN 46825
indianalicensing.org
ID 22437760
LAST UPDATED 2021-03-16 12:42:36 UTC

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