License holder summary

ORAL AND MAXILLO FACIAL is a Dentistry Board - Dental Corporation licensed to practice in Indiana. The address on file for ORAL AND MAXILLO FACIAL is SURGERY CENTER OF LAFAYETTE INC, 2020 UNION STREET, LAFAYETTE IN 47904. This licensed professional license is not current. The license was granted 08/26/1981 and expired on 01/31/2004.

Indiana

Professional Licensing Agency

ORAL AND MAXILLO FACIAL
Dentistry Board - Dental Corporation
License number
54000441A
Date granted
08/26/1981
Date expires
01/31/2004
Class
Dentistry Board - Dental Corporation
Status
Expired
Address
SURGERY CENTER OF LAFAYETTE INC, 2020 UNION STREET, LAFAYETTE IN 47904
indianalicensing.org
ID 24746133
LAST UPDATED 2026-05-07 18:23:49 UTC

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