JOHANNA K MANOUS - Dentist License in Indiana | # 31*****53

JOHANNA K MANOUS

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****53

License Status

ACTIVE

Business

N

First Name

JOHANNA K

Last Name

MANOUS

Business Name

JOHANNA K MANOUS

Original Issue Date

11/15/2018

Effective Date

08/07/2024

Expiration Date

09/30/2027

State

IN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

N

LastModifiedDate

08/07/2024