License holder summary

Richard Tracy Ellison is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Richard Tracy Ellison is 1602 WEST JACKSON STREET, MUNCIE IN 47304. This licensed professional license is current. The license was granted 06/30/1986 and expired on 03/01/2016.

Indiana

Professional Licensing Agency

Richard Tracy Ellison
Controlled Substance Registration - Dentist
License number
12006592B
Date granted
06/30/1986
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
1602 WEST JACKSON STREET, MUNCIE IN 47304
indianalicensing.org
ID 5114283
LAST UPDATED 2024-03-11 11:16:32 UTC

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