Patricia Humphrey Clark
Controlled Substance Registration - Dentist
Indiana 12007844B Active
This Indiana license is held by Patricia Humphrey Clark. The license is currently active. It was granted on 07/31/1986 and expired on 03/01/2016
LICENSE DETAILS
- License Number: 12007844B
- Category: CSR-Dentist
- Status: Active
- Date Granted: 07/31/1986 (almost 39 years ago)
- Expiry Date: 03/01/2016 (about 9 years ago)
LOCATIONS
A Address
221 SOUTH 19TH STREET, TERRE HAUTE IN 47807
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