License holder summary

HERBERT O TIETZER JR is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for HERBERT O TIETZER JR is 1107 ROESKE TRAIL, MICHIGAN CITY IN 46360. This licensed professional license is not current. The license was granted 07/31/1985 and expired on 03/01/1996.

Indiana

Professional Licensing Agency

HERBERT O TIETZER JR
Controlled Substance Registration - Dentist
License number
12005510B
Date granted
07/31/1985
Date expires
03/01/1996
Class
Controlled Substance Registration - Dentist
Status
Expired
Address
1107 ROESKE TRAIL, MICHIGAN CITY IN 46360
indianalicensing.org
ID 5111751
LAST UPDATED 2024-02-03 01:52:42 UTC

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