The holder whose full name is Pemberton, Berkeley M,come from OUT OF STATE IN,hold the CSR-Dentist license(NO.12008224B) which status is Expired.
| Name | Pemberton, Berkeley M |
|---|---|
| License Number | 12008224B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | OUT OF STATE |
| State | IN |