License holder summary

Susan Elaine Wagner is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Susan Elaine Wagner is 8849 Shelby Street, Suite A2, Indianapolis IN 46227. This licensed professional license is current. The license was granted 10/03/1985 and expired on 03/01/2016.

Indiana

Professional Licensing Agency

Susan Elaine Wagner
Controlled Substance Registration - Dentist
License number
12008739B
Date granted
10/03/1985
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
8849 Shelby Street, Suite A2, Indianapolis IN 46227
indianalicensing.org
ID 22437760
LAST UPDATED 2021-03-23 18:48:12 UTC

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