The holder whose full name is BORMANN, DONALD I,come from MICHIGAN CITY IN,hold the CSR-Dentist license(NO.12005193B) which status is Expired.
| Name | BORMANN, DONALD I |
|---|---|
| License Number | 12005193B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | MICHIGAN CITY |
| State | IN |