The holder whose full name is Beach, Wayne William,come from DECATUR IN,hold the CSR-Dentist license(NO.12008961B) which status is Expired.
| Name | Beach, Wayne William |
|---|---|
| License Number | 12008961B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | DECATUR |
| State | IN |