The holder whose full name is Johnston, Derrick Allen,come from Noblesville IN,hold the CSR-Dentist license(NO.12009722B) which status is Active.
| Name | Johnston, Derrick Allen |
|---|---|
| License Number | 12009722B |
| License Type | CSR-Dentist |
| License Status | Active |
| City | Noblesville |
| State | IN |