License holder summary

Frederick Larsen is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Frederick Larsen is 110 E VAN TREES ST, WASHINGTON IN 47501. This licensed professional license is not current. The license was granted 06/19/1991 and expired on 03/01/1994.

Indiana

Professional Licensing Agency

Frederick Larsen
Controlled Substance Registration - Dentist
License number
12007686B
Date granted
06/19/1991
Date expires
03/01/1994
Class
Controlled Substance Registration - Dentist
Status
Suspended
Address
110 E VAN TREES ST, WASHINGTON IN 47501
indianalicensing.org
ID 5127450
LAST UPDATED 2022-06-13 18:30:04 UTC

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