The holder whose full name is BOLLMAN, CARL WILBUR,come from FRANKFORT IN,hold the CSR-Dentist license(NO.12004891B) which status is Expired.
| Name | BOLLMAN, CARL WILBUR |
|---|---|
| License Number | 12004891B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | FRANKFORT |
| State | IN |