License holder summary

Jeffrey Thomas Beacham is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Jeffrey Thomas Beacham is AFDENT, 4041 Parnell Avenue, Fort Wayne IN 46805. This licensed professional license is current. The license was granted 06/17/2011 and expired on 03/01/2016.

Indiana

Professional Licensing Agency

Jeffrey Thomas Beacham
Controlled Substance Registration - Dentist
License number
12011662B
Date granted
06/17/2011
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
AFDENT, 4041 Parnell Avenue, Fort Wayne IN 46805
indianalicensing.org
ID 5095060
LAST UPDATED 2024-01-19 18:10:27 UTC

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