License holder summary

Michael Eugene Shambaugh is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Michael Eugene Shambaugh is 1320 MEDICAL PARK DRIVE, FORT WAYNE IN 46825. This licensed professional license is current. The license was granted 06/27/1988 and expired on 03/01/2016.

Indiana

Professional Licensing Agency

Michael Eugene Shambaugh
Controlled Substance Registration - Dentist
License number
12009044B
Date granted
06/27/1988
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
1320 MEDICAL PARK DRIVE, FORT WAYNE IN 46825
indianalicensing.org
ID 5095422
LAST UPDATED 2024-02-20 04:23:59 UTC

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