The holder whose full name is Altenhof, Carl Richard,come from Portage IN,hold the CSR-Dentist license(NO.12006679B) which status is Active.
| Name | Altenhof, Carl Richard |
|---|---|
| License Number | 12006679B |
| License Type | CSR-Dentist |
| License Status | Active |
| City | Portage |
| State | IN |