The holder whose full name is FISHER, ANTHONY WAYNE,come from ALEXANDRIA IN,hold the CSR-Dentist license(NO.12004688B) which status is Expired.
| Name | FISHER, ANTHONY WAYNE |
|---|---|
| License Number | 12004688B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | ALEXANDRIA |
| State | IN |