License holder summary

Shannon Kennth Moore is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Shannon Kennth Moore is 219 East 17th Street, Bloomington IN 47401. This licensed professional license is current. The license was granted 11/15/2000 and expired on 03/01/2016.

Indiana

Professional Licensing Agency

Shannon Kennth Moore
Controlled Substance Registration - Dentist
License number
12010311B
Date granted
11/15/2000
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
219 East 17th Street, Bloomington IN 47401
indianalicensing.org
ID 5083522
LAST UPDATED 2024-03-08 23:36:00 UTC

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