License holder summary

Stephen Randall Fugaj is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Stephen Randall Fugaj is 9207 Wicker Avenue, Saint John IN 46373. This licensed professional license is current. The license was granted 06/01/2012 and expired on 03/01/2016.

Indiana

Professional Licensing Agency

Stephen Randall Fugaj
Controlled Substance Registration - Dentist
License number
12011816B
Date granted
06/01/2012
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
9207 Wicker Avenue, Saint John IN 46373
indianalicensing.org
ID 5120972
LAST UPDATED 2024-02-14 16:43:17 UTC

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