The holder whose full name is Henrikson, Brett Anthony,come from Lafayette IN,hold the CSR-Dentist license(NO.12010155B) which status is Active.
| Name | Henrikson, Brett Anthony |
|---|---|
| License Number | 12010155B |
| License Type | CSR-Dentist |
| License Status | Active |
| City | Lafayette |
| State | IN |