The holder whose full name is KIPPLE, EUGENE ROBERT,come from TERRE HAUTE, IND. IN,hold the CSR-Dentist license(NO.12004617B) which status is Expired.
| Name | KIPPLE, EUGENE ROBERT |
|---|---|
| License Number | 12004617B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | TERRE HAUTE, IND. |
| State | IN |