The holder whose full name is OBRIEN, CHARLES VAN,come from INDIANAPOLIS IN,hold the CSR-Dentist license(NO.12004523B) which status is Expired.
Name | OBRIEN, CHARLES VAN |
---|---|
License Number | 12004523B |
License Type | CSR-Dentist |
License Status | Expired |
City | INDIANAPOLIS |
State | IN |