The holder whose full name is Porter, Benjamin Lloyd,come from La Porte IN,hold the CSR-Dentist license(NO.12011510B) which status is Expired.
| Name | Porter, Benjamin Lloyd |
|---|---|
| License Number | 12011510B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | La Porte |
| State | IN |