License holder summary

PHILLIP E O SHAUGHNESSY is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for PHILLIP E O SHAUGHNESSY is 6814 COVINGTON CREEK TRAIL, FORT WAYNE IN 46804. This licensed professional license is not current. The license was granted 08/31/1986 and expired on 03/01/2000.

Indiana

Board of Licensing

PHILLIP E O SHAUGHNESSY
Controlled Substance Registration - Dentist
License number
12005741B
Date granted
08/31/1986
Date expires
03/01/2000
Class
Controlled Substance Registration - Dentist
Status
Expired
Address
6814 COVINGTON CREEK TRAIL, FORT WAYNE IN 46804
indianalicensing.org
ID 22437760
LAST UPDATED 2021-02-11 04:58:40 UTC

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