License holder summary

Indiana State Prison-Dental is a Radiology - Radiation Facility Dental licensed to practice in Indiana. The address on file for Indiana State Prison-Dental is 1 Park Road, Michigan City IN 46360. This licensed professional license is current. The license was granted 12/21/2012 and expired on 12/21/2015.

Indiana

Professional Licensing Agency

Indiana State Prison-Dental
Radiology - Radiation Facility Dental
License number
XF903423
Date granted
12/21/2012
Date expires
12/21/2015
Class
Radiology - Radiation Facility Dental
Status
Active
Address
1 Park Road, Michigan City IN 46360
indianalicensing.org
ID 24934583
LAST UPDATED 2024-05-13 17:05:10 UTC

This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.

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