The holder whose full name is Miles, Dale Allan,come from INDIANAPOLIS IN,hold the CSR-Dentist license(NO.12009161B) which status is Expired.
| Name | Miles, Dale Allan |
|---|---|
| License Number | 12009161B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | INDIANAPOLIS |
| State | IN |