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 2024-01-25 09:46:06 UTC
LAST UPDATED 2024-01-25 09:46:06 UTC
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