License holder summary

Wallace Richard Leyda is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Wallace Richard Leyda is 2221 East Covenanter Drive, Bloomington IN 47401. This licensed professional license is not current. The license was granted 05/31/1986 and expired on 03/01/2010.

Indiana

Professional Licensing Agency

Wallace Richard Leyda
Controlled Substance Registration - Dentist
License number
12005731B
Date granted
05/31/1986
Date expires
03/01/2010
Class
Controlled Substance Registration - Dentist
Status
Expired
Address
2221 East Covenanter Drive, Bloomington IN 47401
indianalicensing.org
ID 5083612
LAST UPDATED 2024-04-21 20:27:21 UTC

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