The holder whose full name is Coburn, Charles D.,come from Valparaiso IN,hold the CSR-Dentist license(NO.12006381B) which status is Expired.
| Name | Coburn, Charles D. |
|---|---|
| License Number | 12006381B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | Valparaiso |
| State | IN |