License holder summary

Philippe Bautista is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Philippe Bautista is 412 Hale Road, Clarksville IN 47129. This licensed professional license is current. The license was granted 09/13/2006 and expired on 03/01/2016.

Indiana

Professional Licensing Agency

Philippe Bautista
Controlled Substance Registration - Dentist
License number
12010902B
Date granted
09/13/2006
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
412 Hale Road, Clarksville IN 47129
indianalicensing.org
ID 5087129
LAST UPDATED 2024-02-19 18:47:02 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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