The holder whose full name is Parks, Edwin Thomas,come from INDIANAPOLIS IN,hold the CSR-Dentist license(NO.12009393C) which status is Expired.
| Name | Parks, Edwin Thomas |
|---|---|
| License Number | 12009393C |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | INDIANAPOLIS |
| State | IN |