The holder whose full name is Laderer, Clarence Port,come from SOUTH BEND IN,hold the CSR-Dentist license(NO.12006396B) which status is Expired.
| Name | Laderer, Clarence Port |
|---|---|
| License Number | 12006396B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | SOUTH BEND |
| State | IN |