The holder whose full name is DENTON, CHARLES EDWIN,come from MADISON IN,hold the CSR-Dentist license(NO.12004901B) which status is Expired.
| Name | DENTON, CHARLES EDWIN |
|---|---|
| License Number | 12004901B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | MADISON |
| State | IN |