The holder whose full name is Tiek, Brandon Kenneth,come from Carmel IN,hold the CSR-Dentist license(NO.12010566B) which status is Active.
| Name | Tiek, Brandon Kenneth |
|---|---|
| License Number | 12010566B |
| License Type | CSR-Dentist |
| License Status | Active |
| City | Carmel |
| State | IN |