License holder summary

THOMAS W BENNETT is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for THOMAS W BENNETT is 3030 LAKE AVE #26, FORT WAYNE IN 46805. This licensed professional license is not current. The license was granted 07/31/1986 and expired on 06/30/1991.

Indiana

Professional Licensing Agency

THOMAS W BENNETT
Controlled Substance Registration - Physician
License number
01029202B
Date granted
07/31/1986
Date expires
06/30/1991
Class
Controlled Substance Registration - Physician
Status
Expired
Address
3030 LAKE AVE #26, FORT WAYNE IN 46805
indianalicensing.org
ID 5854654
LAST UPDATED 2024-03-19 23:31:30 UTC

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