License holder summary

Matthew David Haller is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Matthew David Haller is 1220 Mdeical Park Drive, Building 2, Fort Wayne IN 46825. This licensed professional license is current. The license was granted 08/08/1986 and expired on 03/01/2016.

Indiana

Professional Licensing Agency

Matthew David Haller
Controlled Substance Registration - Dentist
License number
12008792B
Date granted
08/08/1986
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
1220 Mdeical Park Drive, Building 2, Fort Wayne IN 46825
indianalicensing.org
ID 5095374
LAST UPDATED 2024-01-18 16:51:56 UTC

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