The holder whose full name is Connelly, Daniel Ray,come from ROME CITY IN,hold the CSR-Dentist license(NO.12007548B) which status is Expired.
| Name | Connelly, Daniel Ray |
|---|---|
| License Number | 12007548B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | ROME CITY |
| State | IN |