The holder whose full name is Shambaugh, Timothy Joseph,come from Fort Wayne IN,hold the CSR-Dentist license(NO.12007177B) which status is Active.
| Name | Shambaugh, Timothy Joseph |
|---|---|
| License Number | 12007177B |
| License Type | CSR-Dentist |
| License Status | Active |
| City | Fort Wayne |
| State | IN |