The holder whose full name is COOK, CARLTON THOMAS,come from SOUTH BEND IN,hold the CSR-Dentist license(NO.12005202B) which status is Expired.
| Name | COOK, CARLTON THOMAS |
|---|---|
| License Number | 12005202B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | SOUTH BEND |
| State | IN |