Indiana
Professional Licensing Agency
John Jacob Shank
Controlled Substance Registration - Dentist
License number
12009584B
Date granted
10/13/1993
Date expires
03/01/2012
Class
Controlled Substance Registration - Dentist
Status
Expired
Address
2121 East Dupont Road, Suite C, Fort Wayne IN 46825
indianalicensing.org
ID 5095109
LAST UPDATED 2024-01-12 00:11:34 UTC
LAST UPDATED 2024-01-12 00:11:34 UTC
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