License holder summary

Periodontics Specialists is a Radiology - Radiation Facility Dental licensed to practice in Indiana. The address on file for Periodontics Specialists is 7750 West Jefferson Boulevard, Fort Wayne IN 46804-4136. This licensed professional license is current. The license was granted 08/10/2004 and expired on 05/13/2016.

Indiana

Professional Licensing Agency

Periodontics Specialists
Radiology - Radiation Facility Dental
License number
XF903062
Date granted
08/10/2004
Date expires
05/13/2016
Class
Radiology - Radiation Facility Dental
Status
Active
Address
7750 West Jefferson Boulevard, Fort Wayne IN 46804-4136
indianalicensing.org
ID 24932327
LAST UPDATED 2024-05-02 15:32:54 UTC

This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.

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