License holder summary

Timothy Joseph Shambaugh is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Timothy Joseph Shambaugh is 1320 Medical Park Drive, Fort Wayne IN 46825. This licensed professional license is current. The license was granted 07/31/1983 and expired on 03/01/2016.

Indiana

Professional Licensing Agency

Timothy Joseph Shambaugh
Controlled Substance Registration - Dentist
License number
12007177B
Date granted
07/31/1983
Date expires
03/01/2016
Class
Controlled Substance Registration - Dentist
Status
Active
Address
1320 Medical Park Drive, Fort Wayne IN 46825
indianalicensing.org
ID 5096277
LAST UPDATED 2021-11-12 09:37:51 UTC

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