License holder summary

Patrick Keone Miyamasu is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Patrick Keone Miyamasu is Familia Dental, 5328 Coldwater Road, Fort Wayne IN 46825. This licensed professional license is current. The license was granted 03/04/2014 and expired on 03/01/2016.

Indiana

Professional Licensing Agency

Patrick Keone Miyamasu
Controlled Substance Registration - Dentist
License number
12011921B
Date granted
03/04/2014
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
Familia Dental, 5328 Coldwater Road, Fort Wayne IN 46825
indianalicensing.org
ID 27545589
LAST UPDATED 2024-03-25 23:27:03 UTC

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