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