The holder whose full name is LECKLITNER, DONALD MAX,come from LAFAYETTE IN,hold the CSR-Dentist license(NO.12005562B) which status is Expired.
Name | LECKLITNER, DONALD MAX |
---|---|
License Number | 12005562B |
License Type | CSR-Dentist |
License Status | Expired |
City | LAFAYETTE |
State | IN |