The holder whose full name is Ottilie, David J.,come from PLAINFIELD IN,hold the CSR-Dentist license(NO.12008013C) which status is Expired.
| Name | Ottilie, David J. |
|---|---|
| License Number | 12008013C |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | PLAINFIELD |
| State | IN |