The holder whose full name is Cibock, Duane James,come from PORTAGE IN,hold the CSR-Dentist license(NO.12005761B) which status is Expired.
| Name | Cibock, Duane James |
|---|---|
| License Number | 12005761B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | PORTAGE |
| State | IN |