The holder whose full name is Mortenson, David Glen,come from New Albany IN,hold the CSR-Dentist license(NO.12011594B) which status is Expired.
| Name | Mortenson, David Glen |
|---|---|
| License Number | 12011594B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | New Albany |
| State | IN |