Stephen Travis Petty

Controlled Substance Registration - Dentist

Indiana  12012050B   Active

This Indiana license is held by Stephen Travis Petty. The license is currently active. It was granted on 12/16/2013 and expired on 03/01/2016

LICENSE DETAILS

  • License Number: 12012050B
  • Category: CSR-Dentist
  • Status: Active
  • Date Granted: 12/16/2013 (over 11 years ago)
  • Expiry Date: 03/01/2016 (over 9 years ago)

LOCATIONS

A Address

1852 Bluffton Rd., Fort Wayne IN 46809