License holder summary

South Street Family Dental is a Radiology - Radiation Facility Dental licensed to practice in Indiana. The address on file for South Street Family Dental is 103 North Farabee Drive, Suite C, Lafayette IN 47905-5909. This licensed professional license is current. The license was granted 09/23/2005 and expired on 09/23/2014.

Indiana

Professional Licensing Agency

South Street Family Dental
Radiology - Radiation Facility Dental
License number
XF900734
Date granted
09/23/2005
Date expires
09/23/2014
Class
Radiology - Radiation Facility Dental
Status
Active
Address
103 North Farabee Drive, Suite C, Lafayette IN 47905-5909
indianalicensing.org
ID 24934213
LAST UPDATED 2024-02-22 03:09:48 UTC

This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.

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