License holder summary

Thomas R. Clark is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Thomas R. Clark is 3410 W. Purdue Ave., Muncie IN 47304. This licensed professional license is current. The license was granted 09/30/1986 and expired on 03/01/2016.

Indiana

Professional Licensing Agency

Thomas R. Clark
Controlled Substance Registration - Dentist
License number
12007845B
Date granted
09/30/1986
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
3410 W. Purdue Ave., Muncie IN 47304
indianalicensing.org
ID 22437760
LAST UPDATED 2021-04-03 00:09:45 UTC

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