The holder whose full name is Carlson, David Lee,come from Fort Wayne IN,hold the CSR-Dentist license(NO.12010337C) which status is Active.
| Name | Carlson, David Lee |
|---|---|
| License Number | 12010337C |
| License Type | CSR-Dentist |
| License Status | Active |
| City | Fort Wayne |
| State | IN |