Indiana
Professional Licensing Agency
Richard D. Stackert
Controlled Substance Registration - Dentist
License number
12006988B
Date granted
01/31/1986
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
506 East Evans Avenue, Valparaiso IN 46383
indianalicensing.org
ID 5126309
LAST UPDATED 2024-04-29 23:07:32 UTC
LAST UPDATED 2024-04-29 23:07:32 UTC
This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.