License holder summary

Patricia Humphrey Clark is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Patricia Humphrey Clark is 221 SOUTH 19TH STREET, TERRE HAUTE IN 47807. This licensed professional license is current. The license was granted 07/31/1986 and expired on 03/01/2016.

Indiana

Professional Licensing Agency

Patricia Humphrey Clark
Controlled Substance Registration - Dentist
License number
12007844B
Date granted
07/31/1986
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
221 SOUTH 19TH STREET, TERRE HAUTE IN 47807
indianalicensing.org
ID 5125244
LAST UPDATED 2024-02-13 22:54:30 UTC

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