License holder summary

John Jacob Shank is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for John Jacob Shank is 2121 East Dupont Road, Suite C, Fort Wayne IN 46825. This licensed professional license is not current. The license was granted 10/13/1993 and expired on 03/01/2012.

Indiana

Board of Licensing

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 22437760
LAST UPDATED 2021-01-21 11:07:25 UTC

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