License holder summary

Randall David Stastny is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Randall David Stastny is 368 BIELBY RD SUITE 130, LAWRENCEBURG IN 47025. This licensed professional license is not current. The license was granted 09/23/1997 and expired on 03/01/2004.

Indiana

Professional Licensing Agency

Randall David Stastny
Controlled Substance Registration - Dentist
License number
12009996B
Date granted
09/23/1997
Date expires
03/01/2004
Class
Controlled Substance Registration - Dentist
Status
Expired
Address
368 BIELBY RD SUITE 130, LAWRENCEBURG IN 47025
indianalicensing.org
ID 5108424
LAST UPDATED 2024-04-05 07:38:23 UTC

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