License holder summary

Kathryn Anne Simon is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Kathryn Anne Simon is 170 South Creasy Lane #1730, Lafayette IN 47905. This licensed professional license is not current. The license was granted 07/21/2009 and expired on 03/01/2012.

Indiana

Professional Licensing Agency

Kathryn Anne Simon
Controlled Substance Registration - Dentist
License number
12011202B
Date granted
07/21/2009
Date expires
03/01/2012
Class
Controlled Substance Registration - Dentist
Status
Expired
Address
170 South Creasy Lane #1730, Lafayette IN 47905
indianalicensing.org
ID 5107709
LAST UPDATED 2024-02-01 15:44:01 UTC

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