License holder summary

Philip C Roach is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Philip C Roach is 2121 East Dupont Road, Suite B, Fort Wayne IN 46825-1546. This licensed professional license is current. The license was granted 09/30/1985 and expired on 03/01/2016.

Indiana

Professional Licensing Agency

Philip C Roach
Controlled Substance Registration - Dentist
License number
12008612B
Date granted
09/30/1985
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
2121 East Dupont Road, Suite B, Fort Wayne IN 46825-1546
indianalicensing.org
ID 5095556
LAST UPDATED 2024-04-13 20:22:04 UTC

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