The holder whose full name is Middleton, Charles Mathew,come from Fort Wayne IN,hold the CSR-Dentist license(NO.12011467B) which status is Active.
| Name | Middleton, Charles Mathew |
|---|---|
| License Number | 12011467B |
| License Type | CSR-Dentist |
| License Status | Active |
| City | Fort Wayne |
| State | IN |