License holder summary

Jennifer Ann Southard is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Jennifer Ann Southard is 605 W Douglas Rd, Mishawaka IN 46545. This licensed professional license is current. The license was granted 05/31/2013 and expired on 03/01/2016.

Indiana

Professional Licensing Agency

Jennifer Ann Southard
Controlled Substance Registration - Dentist
License number
12011968B
Date granted
05/31/2013
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
605 W Douglas Rd, Mishawaka IN 46545
indianalicensing.org
ID 5110144
LAST UPDATED 2024-04-25 06:04:41 UTC

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