The holder whose full name is LOWRY, CHARLES HAVEN,come from LOGANSPORT IN,hold the CSR-Dentist license(NO.12004564B) which status is Expired.
Name | LOWRY, CHARLES HAVEN |
---|---|
License Number | 12004564B |
License Type | CSR-Dentist |
License Status | Expired |
City | LOGANSPORT |
State | IN |