The holder whose full name is FREAD, DONALD BURTON,come from TERRE HAUTE IN,hold the CSR-Dentist license(NO.12005210B) which status is Expired.
| Name | FREAD, DONALD BURTON |
|---|---|
| License Number | 12005210B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | TERRE HAUTE |
| State | IN |