The holder whose full name is Bleeke, David Alton,come from FORT WAYNE IN,hold the CSR-Dentist license(NO.12006082B) which status is Expired.
| Name | Bleeke, David Alton |
|---|---|
| License Number | 12006082B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | FORT WAYNE |
| State | IN |