Indiana
Professional Licensing Agency
Southport Dental, P.C.
Dentistry Board - Dental Corporation
License number
54001468A
Date granted
08/09/2005
Date expires
01/31/2014
Class
Dentistry Board - Dental Corporation
Status
Expired
Address
8028 South Emerson Avenue, Indianapolis IN 46237
indianalicensing.org
ID 24745779
LAST UPDATED 2024-05-16 01:17:01 UTC
LAST UPDATED 2024-05-16 01:17:01 UTC
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