Indiana
Professional Licensing Agency
Pediatric Dentistry, Inc.
Dentistry Board - Dental Corporation
License number
54000382A
Date granted
10/30/1980
Date expires
01/31/2008
Class
Dentistry Board - Dental Corporation
Status
Expired Non-Renewable
Address
7750 WEST JEFFERSON BLVD, FORT WAYNE IN 46804
indianalicensing.org
ID 24744325
LAST UPDATED 2026-05-13 20:29:17 UTC
LAST UPDATED 2026-05-13 20:29:17 UTC
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