The holder whose full name is Haskell, Douglas Alan,come from VALPARAISO IN,hold the CSR-Dentist license(NO.12007426B) which status is Expired.
| Name | Haskell, Douglas Alan |
|---|---|
| License Number | 12007426B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | VALPARAISO |
| State | IN |