License holder summary

Thomas M. Banta, D.D.S. is a Radiology - Radiation Facility Dental licensed to practice in Indiana. The address on file for Thomas M. Banta, D.D.S. is 1413 West Votaw Street, Portland IN 47371-9593. This licensed professional license is current. The license was granted 08/05/2005 and expired on 08/05/2017.

Indiana

Professional Licensing Agency

Thomas M. Banta, D.D.S.
Radiology - Radiation Facility Dental
License number
XF900574
Date granted
08/05/2005
Date expires
08/05/2017
Class
Radiology - Radiation Facility Dental
Status
Active
Address
1413 West Votaw Street, Portland IN 47371-9593
indianalicensing.org
ID 24935392
LAST UPDATED 2024-04-01 01:09:35 UTC

This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.

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