JOHANNA K MANOUS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****53

License Status

ACTIVE

Business

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

City

MUNSTER

State

Zip

46321

County

INDIANA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/07/2024