Indiana
Professional Licensing Agency
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 5095600
LAST UPDATED 2024-04-20 07:18:54 UTC
LAST UPDATED 2024-04-20 07:18:54 UTC
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