The holder whose full name is BURNS, WALTER RICHARD,come from PLYMOUTH IN,hold the CSR-Dentist license(NO.12005540B) which status is Expired.
| Name | BURNS, WALTER RICHARD |
|---|---|
| License Number | 12005540B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | PLYMOUTH |
| State | IN |