The holder whose full name is Ham, Delbert Wayne,come from OUT OF STATE NY,hold the CSR-Dentist license(NO.12008313B) which status is Expired.
| Name | Ham, Delbert Wayne |
|---|---|
| License Number | 12008313B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | OUT OF STATE |
| State | NY |