Stephen J. Fairchild

Controlled Substance Registration - Dentist

Indiana  12007855E   Expired

This Indiana license was held by Stephen J. Fairchild. The license is no longer active. It was granted on 03/14/1990 and expired on 03/01/1994

LICENSE DETAILS

  • License Number: 12007855E
  • Category: CSR-Dentist
  • Status: Expired
  • Date Granted: 03/14/1990 (over 34 years ago)
  • Expiry Date: 03/01/1994 (over 30 years ago)

LOCATIONS

A Address

ORAL SURGERY GROUP INC, 5939 CENTRAL AVENUE, PORTAGE IN 46368