The holder whose full name is LEVY, VIRGIL L,come from FORT WAYNE IN,hold the CSR-Dentist license(NO.12004770B) which status is Expired.
| Name | LEVY, VIRGIL L |
|---|---|
| License Number | 12004770B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | FORT WAYNE |
| State | IN |