Michael Vanice Ellis

Controlled Substance Registration - Dentist

Indiana  12006819B   Active

This Indiana license is held by Michael Vanice Ellis. The license is currently active. It was granted on 04/17/1989 and expired on 03/01/2016

LICENSE DETAILS

  • License Number: 12006819B
  • Category: CSR-Dentist
  • Status: Active
  • Date Granted: 04/17/1989 (about 36 years ago)
  • Expiry Date: 03/01/2016 (about 9 years ago)

LOCATIONS

A Address

P.O. Box 38, 305 North Meridian Street, Holland IN 47541