Timothy Joseph Shambaugh
Controlled Substance Registration - Dentist
Indiana 12007177B Active
This Indiana license is held by Timothy Joseph Shambaugh. The license is currently active. It was granted on 07/31/1983 and expired on 03/01/2016
LICENSE DETAILS
- License Number: 12007177B
- Category: CSR-Dentist
- Status: Active
- Date Granted: 07/31/1983 (almost 42 years ago)
- Expiry Date: 03/01/2016 (over 9 years ago)
LOCATIONS
A Address
1320 Medical Park Drive, Fort Wayne IN 46825
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