License holder summary

Phillip R. Douglas is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Phillip R. Douglas is Putnamville Correctional Facility, 1500 West U.S. 40, Greencastle IN 46135. This licensed professional license is not current. The license was granted 06/17/2008 and expired on 03/01/2010.

Indiana

Professional Licensing Agency

Phillip R. Douglas
Controlled Substance Registration - Dentist
License number
12011180B
Date granted
06/17/2008
Date expires
03/01/2010
Class
Controlled Substance Registration - Dentist
Status
Expired
Address
Putnamville Correctional Facility, 1500 West U.S. 40, Greencastle IN 46135
indianalicensing.org
ID 5098658
LAST UPDATED 2024-02-09 04:27:26 UTC

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