License holder summary

Jeffrey Joseph Shambaugh is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Jeffrey Joseph Shambaugh is 4341 FlagStaff Cove, Fort Wayne IN 46815-4400. This licensed professional license is current. The license was granted 06/25/2004 and expired on 03/01/2016.

Indiana

Professional Licensing Agency

Jeffrey Joseph Shambaugh
Controlled Substance Registration - Dentist
License number
12010642B
Date granted
06/25/2004
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
4341 FlagStaff Cove, Fort Wayne IN 46815-4400
indianalicensing.org
ID 5095045
LAST UPDATED 2024-04-12 21:21:31 UTC

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