The holder whose full name is BOSH, EDWARD E,come from LOGANSPORT IN,hold the CSR-Dentist license(NO.12004777B) which status is Expired.
| Name | BOSH, EDWARD E |
|---|---|
| License Number | 12004777B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | LOGANSPORT |
| State | IN |