License holder summary

Richard Michael Dziak is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Richard Michael Dziak is Afdent Dental Services, 605 West Douglas Road, Mishawaka IN 46545. This licensed professional license is current. The license was granted 10/14/2005 and expired on 03/01/2016.

Indiana

Professional Licensing Agency

Richard Michael Dziak
Controlled Substance Registration - Dentist
License number
12009517B
Date granted
10/14/2005
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
Afdent Dental Services, 605 West Douglas Road, Mishawaka IN 46545
indianalicensing.org
ID 5112668
LAST UPDATED 2024-04-06 06:12:58 UTC

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