Indiana
Professional Licensing Agency
SOUTHPORT DENTAL GROUP, P.C.
Dentistry Board - Dental Corporation
License number
54001305A
Date granted
03/06/2002
Date expires
01/31/2004
Class
Dentistry Board - Dental Corporation
Status
Expired
Address
8028 SOUTH EMERSON AVENUE, UNIT A/B, Indianapolis IN 46237
indianalicensing.org
ID 24745772
LAST UPDATED 2026-04-30 14:03:03 UTC
LAST UPDATED 2026-04-30 14:03:03 UTC
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