Indiana
Professional Licensing Agency
FAMILY DENTAL PRACTICE
Dentistry Board - Dental Corporation
License number
54000360A
Date granted
01/31/1986
Date expires
01/31/1998
Class
Dentistry Board - Dental Corporation
Status
Expired
Address
205 FIELDSTONE DRIVE, LAPORTE IN 46350
indianalicensing.org
ID 24746066
LAST UPDATED 2026-06-15 02:28:48 UTC
LAST UPDATED 2026-06-15 02:28:48 UTC
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