License holder summary

Gerry Lee Kaufman is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Gerry Lee Kaufman is 4606-B E STATE BLVD, FORT WAYNE IN 46815. This licensed professional license is not current. The license was granted 05/31/1986 and expired on 03/01/2008.

Indiana

Professional Licensing Agency

Gerry Lee Kaufman
Controlled Substance Registration - Dentist
License number
12006394B
Date granted
05/31/1986
Date expires
03/01/2008
Class
Controlled Substance Registration - Dentist
Status
Expired
Address
4606-B E STATE BLVD, FORT WAYNE IN 46815
indianalicensing.org
ID 5094704
LAST UPDATED 2024-03-19 17:54:57 UTC

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