PHILLIP E O SHAUGHNESSY
Controlled Substance Registration - Dentist
Indiana 12005741B Expired
This Indiana license was held by PHILLIP E O SHAUGHNESSY. The license is no longer active. It was granted on 08/31/1986 and expired on 03/01/2000
LICENSE DETAILS
- License Number: 12005741B
- Category: CSR-Dentist
- Status: Expired
- Date Granted: 08/31/1986 (over 37 years ago)
- Expiry Date: 03/01/2000 (about 24 years ago)
LOCATIONS
A Address
6814 COVINGTON CREEK TRAIL, FORT WAYNE IN 46804