License holder summary

Ken J. Roller, D.D.S. is a Radiology - Radiation Facility Dental licensed to practice in Indiana. The address on file for Ken J. Roller, D.D.S. is 4656 West Jefferson Blvd, Suite 250, Fort Wayne IN 46804-6833. This licensed professional license is not current. The license was granted 03/23/2001 and expired on 12/30/2003.

Indiana

Professional Licensing Agency

Ken J. Roller, D.D.S.
Radiology - Radiation Facility Dental
License number
XF900087
Date granted
03/23/2001
Date expires
12/30/2003
Class
Radiology - Radiation Facility Dental
Status
Closed Facility
Address
4656 West Jefferson Blvd, Suite 250, Fort Wayne IN 46804-6833
indianalicensing.org
ID 24932283
LAST UPDATED 2024-04-10 00:03:48 UTC

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