License holder summary

Lafayette Oral and Maxillofacial Surgery Group is a Radiology - Radiation Facility Dental licensed to practice in Indiana. The address on file for Lafayette Oral and Maxillofacial Surgery Group is 953 Park East Boulevard, Lafayette IN 47905. This licensed professional license is current. The license was granted 07/01/2004 and expired on 10/09/2017.

Indiana

Professional Licensing Agency

Lafayette Oral and Maxillofacial Surgery Group
Radiology - Radiation Facility Dental
License number
XF900165
Date granted
07/01/2004
Date expires
10/09/2017
Class
Radiology - Radiation Facility Dental
Status
Active
Address
953 Park East Boulevard, Lafayette IN 47905
indianalicensing.org
ID 24934183
LAST UPDATED 2024-03-29 02:10:01 UTC

This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.

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