The holder whose full name is ELLIS, EUGENE E,come from ELKHART IN,hold the CSR-Dentist license(NO.12005012B) which status is Expired.
| Name | ELLIS, EUGENE E |
|---|---|
| License Number | 12005012B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | ELKHART |
| State | IN |