The holder whose full name is Follis, David Michael,come from South Bend IN,hold the CSR-Dentist license(NO.12010354B) which status is Active.
| Name | Follis, David Michael |
|---|---|
| License Number | 12010354B |
| License Type | CSR-Dentist |
| License Status | Active |
| City | South Bend |
| State | IN |