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