Sonya Ann Shively
Controlled Substance Registration - Dentist
Indiana 12010188B Active
This Indiana license is held by Sonya Ann Shively. The license is currently active. It was granted on 08/13/1999 and expired on 03/01/2016
LICENSE DETAILS
- License Number: 12010188B
- Category: CSR-Dentist
- Status: Active
- Date Granted: 08/13/1999 (almost 25 years ago)
- Expiry Date: 03/01/2016 (over 8 years ago)
LOCATIONS
A Address
4616 West Jefferson Boulevard, Fort Wayne IN 46804-6826
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