PHIL N RUCKMAN III - Dentist License in Indiana | # 137000925

PHIL N RUCKMAN III

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000925

License Status

NOT RENEWED

Business

N

First Name

PHIL

Middle

N

Last Name

RUCKMAN III

Business Name

PHIL N RUCKMAN III

Original Issue Date

07/29/2015

Effective Date

10/21/2021

Expiration Date

09/30/2024

State

IN

Specialty/Qualifier

DEEP SEDATION AND GENERAL ANESTHESIA

Ever Disciplined

N

LastModifiedDate

02/04/2025