The holder whose full name is Peters, Thomas Robert,come from Portage IN,hold the CSR-Dentist license(NO.12007708B) which status is Expired.
| Name | Peters, Thomas Robert |
|---|---|
| License Number | 12007708B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | Portage |
| State | IN |