License holder summary

Steven Gary Jacob is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Steven Gary Jacob is 7210 Maplecrest Road, Fort Wayne IN 46835. This licensed professional license is current. The license was granted 11/10/2003 and expired on 03/01/2016.

Indiana

Professional Licensing Agency

Steven Gary Jacob
Controlled Substance Registration - Dentist
License number
12010605B
Date granted
11/10/2003
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
7210 Maplecrest Road, Fort Wayne IN 46835
indianalicensing.org
ID 5095992
LAST UPDATED 2024-02-17 18:39:43 UTC

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