License holder summary

Sonya A. Shively, D.D.S.,PC is a Radiology - Radiation Facility Dental licensed to practice in Indiana. The address on file for Sonya A. Shively, D.D.S.,PC is 4616 West Jefferson Boulevard, Fort Wayne IN 46804-6889. This licensed professional license is current. The license was granted 12/03/2003 and expired on 05/10/2016.

Indiana

Professional Licensing Agency

Sonya A. Shively, D.D.S.,PC
Radiology - Radiation Facility Dental
License number
XF900115
Date granted
12/03/2003
Date expires
05/10/2016
Class
Radiology - Radiation Facility Dental
Status
Active
Address
4616 West Jefferson Boulevard, Fort Wayne IN 46804-6889
indianalicensing.org
ID 24932357
LAST UPDATED 2024-04-28 08:11:52 UTC

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