The holder whose full name is Jansen, Douglas Alan,come from Kendallville IN,hold the CSR-Dentist license(NO.12009669B) which status is Active.
| Name | Jansen, Douglas Alan |
|---|---|
| License Number | 12009669B |
| License Type | CSR-Dentist |
| License Status | Active |
| City | Kendallville |
| State | IN |