The holder whose full name is Tate, Brian Paul,come from INDIANAPOLIS IN,hold the CSR-Dentist license(NO.12009788B) which status is Expired.
| Name | Tate, Brian Paul |
|---|---|
| License Number | 12009788B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | INDIANAPOLIS |
| State | IN |